Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13423 | Date 28/08/2025 |
| Token No | SM/25-26/1763 28/08/2025 | Serial | 011 |
| Patient Name | Mr. SAMIR NATH | Contact No | 8697101439 |
| Address | BAIDYABATI | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||