Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13120 | Date 14/06/2025 |
| Token No | SM/25-26/828 14/06/2025 | Serial | 002 |
| Patient Name | Mr. HARINDAR MAHATO | Contact No | 9875322215 |
| Address | 19 AKHRA BATI LANE | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||