Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10349 | Date 31/12/2025 |
| Token No | SM/25-26/12590 31/12/2025 | Serial | 037 |
| Patient Name | Mr. CHANDAN KUMAR PRASAD | Contact No | 9331503377 |
| Address | 368 SHRIKRISHNA NAGAR PRAVASHNAGAR RISHRA 712249 | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||