Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13552 | Date 20/09/2025 |
| Token No | SM/25-26/2137 20/09/2025 | Serial | 011 |
| Patient Name | Mr. PRIYANGSU SHAW | Contact No | 6291126099 |
| Address | 546A G.T. ROAD MANIKTALA | Age | 24 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||