Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11219 | Date 04/03/2024 |
| Token No | SM/24-25/17195 27/06/2024 | Serial | 026 |
| Patient Name | Mr. SHAMBHU NATH DAS | Contact No | 9874146629 |
| Address | 32 DOSTI LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||