Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13591 | Date 10/10/2025 |
| Token No | SM/25-26/2244 10/10/2025 | Serial | 012 |
| Patient Name | Mr. AMARJIT MAJHI | Contact No | 8274036625 |
| Address | DHARMATALA | Age | 60YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||