Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09331 | Date 13/06/2023 |
| Token No | SM/25-26/115 10/04/2025 | Serial | 006 |
| Patient Name | Mr. ARUN DAS | Contact No | 8478912709 |
| Address | 113 R B SARANI | Age | 45 yrs Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||