Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13189 | Date 01/07/2025 |
| Token No | SM/25-26/1045 01/07/2025 | Serial | 002 |
| Patient Name | Mr. BIJOY DAS | Contact No | 8961009477 |
| Address | 40A/1 MADAM BAGAN | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||