Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01365 | Date 06/04/2020 |
| Token No | SM/25-26/12265 22/12/2025 | Serial | 025 |
| Patient Name | Mr. AYUSH KUMAR SINGH | Contact No | 8252336376 |
| Address | SATGHARA P SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||