Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13837 | Date 08/12/2025 |
| Token No | SM/25-26/3069 22/12/2025 | Serial | 007 |
| Patient Name | Mr. BHAGWAN SHAW | Contact No | 9339203236 |
| Address | INDIA JUTE MILL | Age | 80 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||