Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13467 | Date 04/09/2025 |
| Token No | SM/25-26/1893 04/09/2025 | Serial | 003 |
| Patient Name | Mr. NANDALAL MAJHI | Contact No | 9836999434 |
| Address | 21 DR N.L. BHATTACHARJEE STREET | Age | 75 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||