Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10861 | Date 04/12/2023 |
| Token No | SM/25-26/1397 25/07/2025 | Serial | 010 |
| Patient Name | Mr. SACHINDRA SARKHEL | Contact No | 9062123265 |
| Address | 114/B T B STREET | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||