Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12514 | Date 10/01/2025 |
| Token No | SM/24-25/20440 10/01/2025 | Serial | 016 |
| Patient Name | Mr. JAGDISH PRASAD. | Contact No | 8100001636 |
| Address | DEY STREET, PAL BAGAN. | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||