Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 16372 | Date 17/12/2025 |
| Token No | SM/25-26/8849 17/12/2025 | Serial | 011 Last Visit: 17/12/2025 |
| Patient Name | Mr. ASHUTOSH KUMAR PANDEY | Contact No | 8697442348 |
| Address | 162/D TELIPARA LANE BIDHORI SANGHA CLUB | Age | 37 Years,10 Months,27 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||