Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12979 | Date 12/05/2025 |
| Token No | SM/25-26/429 12/05/2025 | Serial | 007 |
| Patient Name | Mr. AJAY RAM | Contact No | 8910857988 |
| Address | 7 DEY GHAT LANE | Age | 20 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||