Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13799 | Date 28/11/2025 |
| Token No | SM/25-26/2811 28/11/2025 | Serial | 008 |
| Patient Name | Mr. ROHIT RAM | Contact No | 9330385093 |
| Address | 4 DEY GHAT LANE | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||