Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13292 | Date 25/07/2025 |
| Token No | SM/25-26/1389 25/07/2025 | Serial | 002 |
| Patient Name | Mr. MADHUSUDAN PAL | Contact No | 9748964898 |
| Address | 45 DR. N L B STREET | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||