Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09599 | Date 12/07/2023 |
| Token No | SM/25-26/2790 27/11/2025 | Serial | 006 |
| Patient Name | Mr. RAJU MAJHI | Contact No | 9674543572 |
| Address | 8 NO LINE, INDIA JUTE MILL | Age | 40 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||