Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12932 | Date 28/04/2025 |
| Token No | SM/25-26/279 28/04/2025 | Serial | 007 |
| Patient Name | Mr. SUSHANT SHA | Contact No | 7686002233 |
| Address | RAM SITA LANE | Age | 4 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||