Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13370 | Date 12/08/2025 |
| Token No | SM/25-26/1641 12/08/2025 | Serial | 002 |
| Patient Name | Mr. SANJIB KUMAR SINGH | Contact No | 9718864186 |
| Address | CHOWDHURY PARA | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||