Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10657 | Date 05/10/2023 |
| Token No | SM/25-26/2053 15/09/2025 | Serial | 010 |
| Patient Name | Mr. RAJENDRA PRASAD TANTI | Contact No | 9163777809 |
| Address | 14 DEY STREET, PALBAGAN | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||