Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13592 | Date 10/10/2025 |
| Token No | SM/25-26/2245 10/10/2025 | Serial | 013 |
| Patient Name | Mr. CHANDRASAR ROY | Contact No | 9038618868 |
| Address | DHARMATALA | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||