Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13580 | Date 09/10/2025 |
| Token No | SM/25-26/2204 09/10/2025 | Serial | 005 |
| Patient Name | Mr. DHIRAJ MALBIYA | Contact No | 8697161759 |
| Address | S.B. GHOSH LANE | Age | 35 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||