Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13282 | Date 24/07/2025 |
| Token No | SM/25-26/1363 24/07/2025 | Serial | 002 |
| Patient Name | Mr. MOTILAL DAS | Contact No | 6291652238 |
| Address | 136 G.T. ROAD MANIKTALA, DEY | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||