Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13822 | Date 03/12/2025 |
| Token No | SM/25-26/2865 03/12/2025 | Serial | 014 |
| Patient Name | Master DIBYANSH RAM | Contact No | 8013548536 |
| Address | 4 DEY GHAT LANE | Age | 2 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||