Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13557 | Date 22/09/2025 |
| Token No | SM/25-26/2147 22/09/2025 | Serial | 002 |
| Patient Name | Mr. SHIBAJI GUHA THAKURATA | Contact No | 7003101188 |
| Address | 3 BECHU DEY LANE | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||