Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13542 | Date 19/09/2025 |
| Token No | SM/25-26/2113 19/09/2025 | Serial | 002 |
| Patient Name | Mr. SUSHANTA DEY | Contact No | 7890061471 |
| Address | 40 NEHERU NAGAR COLONY | Age | 23 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||