Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 12880 | Date 10/04/2025 |
| Token No | SM/25-26/137 11/04/2025 | Serial | 004 |
| Patient Name | Mr. SUJOY PARUI | Contact No | 9674970963 |
| Address | NALIKUL | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||