Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 13419 | Date 28/08/2025 |
| Token No | SM/25-26/1757 28/08/2025 | Serial | 005 |
| Patient Name | Mr. SRIKANTA DAS | Contact No | 7439272277 |
| Address | 640 G.T. ROAD KALITALA | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||