Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12032 | Date 30/08/2024 |
| Token No | SM/25-26/6097 28/10/2026 | Serial | 017 |
| Patient Name | Master ROHAN RAM | Contact No | 8013548536 |
| Address | 4 DEY GHAT LANE | Age | 4 YRS 6 MNTH Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||