Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13859 | Date 12/12/2025 |
| Token No | SM/25-26/2976 12/12/2025 | Serial | 002 |
| Patient Name | Mr. HARENDRA SHAW | Contact No | 9007680377 |
| Address | 8 SHIVTALA LANE | Age | 46 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||