Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13632 | Date 18/10/2025 |
| Token No | SM/25-26/2330 18/10/2025 | Serial | 003 |
| Patient Name | Mr. BINOD DAS | Contact No | 8013891031 |
| Address | CHOWDHURY PARA | Age | 26 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||