Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12578 | Date 27/01/2025 |
| Token No | SM/24-25/20719 27/01/2025 | Serial | 017 |
| Patient Name | Mr. DHARMENDAR DAS | Contact No | 9674618353 |
| Address | K.L. GOSWAMI STREET | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||