Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13180 | Date 30/06/2025 |
| Token No | SM/25-26/1020 30/06/2025 | Serial | 005 |
| Patient Name | Mr. ARJUN DAS | Contact No | 6290021070 |
| Address | PACHU BAZAR | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||