Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12999 | Date 19/05/2025 |
| Token No | SM/25-26/490 19/05/2025 | Serial | 003 |
| Patient Name | Mr. SWASTIK KUMAR | Contact No | 6209865590 |
| Address | 122 R B SARANI | Age | 9 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||