Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13634 | Date 18/10/2025 |
| Token No | SM/25-26/2335 18/10/2025 | Serial | 008 |
| Patient Name | Mr. AJIT BORAL | Contact No | 9038163554 |
| Address | 4B BHAGIRATHI LANE | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||