Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07427 | Date 28/10/2022 |
| Token No | SM/25-26/1022 30/06/2025 | Serial | 007 |
| Patient Name | Mr. SAYAN DAS | Contact No | 7439464021 |
| Address | 36 dosti lane | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||