Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11192 | Date 23/02/2024 |
| Token No | SM/24-25/21491 29/03/2025 | Serial | 011 |
| Patient Name | Mr. KALICHARAN KHATIK | Contact No | NOT GIVEN |
| Address | 82 DEY ST | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||