Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13538 | Date 18/09/2025 |
| Token No | SM/25-26/2105 18/09/2025 | Serial | 028 |
| Patient Name | Mr. KRISHNA RAY | Contact No | 6290746840 |
| Address | 16 SITAL SARKAR LANE | Age | 30 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||