Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 11231 | Date 27/10/2026 |
| Token No | SM/25-26/22671 27/10/2026 | Serial | 007 |
| Patient Name | Mr. BASKI RAM | Contact No | 9836709919 |
| Address | PANCHUGOPAL BHADURI SARANI RISHRA 712249 | Age | 60 Years,6 Months,23 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||