Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13628 | Date 16/10/2025 |
| Token No | SM/25-26/2311 16/10/2025 | Serial | 003 |
| Patient Name | Mr. BHAGIRATHI PRADHAN | Contact No | 6291638856 |
| Address | 2 GOPAL GANGULY LANE | Age | 56 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||