Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11689 | Date 24/06/2024 |
| Token No | SM/25-26/1593 08/08/2025 | Serial | 002 |
| Patient Name | Mr. TANUMAY BRAHMA | Contact No | 9433327203 |
| Address | 43/C DHULIPARA LANE | Age | 35 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||