Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13114 | Date 13/06/2025 |
| Token No | SM/25-26/2377 24/10/2025 | Serial | 002 |
| Patient Name | Mr. SANJAY SEN | Contact No | 9007949894 |
| Address | 592 G T ROAD | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||