Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13532 | Date 18/09/2025 |
| Token No | SM/25-26/2091 18/09/2025 | Serial | 014 |
| Patient Name | Mr. SHIBU DAS | Contact No | 9432651989 |
| Address | 80 DEY STREET | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||