Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13301 | Date 26/07/2025 |
| Token No | SM/25-26/1406 26/07/2025 | Serial | 007 |
| Patient Name | Mr. RANJAN DAS | Contact No | 7044963041 |
| Address | 73 POTUAPARA LANE | Age | 79 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||