Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12798 | Date 19/03/2025 |
| Token No | SM/24-25/21369 19/03/2025 | Serial | 007 |
| Patient Name | Mr. SANTOSH DAS | Contact No | 9875497730 |
| Address | 12 PITAMBAR DEY LANE | Age | 33 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||