Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14766 | Date 18/08/2026 |
| Token No | SM/25-26/6081 28/10/2026 | Serial | 001 |
| Patient Name | Mr. DHARMENDAR SINGH | Contact No | 8240863398 |
| Address | INDIA JUTE MILL | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||