Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13658 | Date 25/10/2025 |
| Token No | SM/25-26/2389 25/10/2025 | Serial | 011 |
| Patient Name | Mr. SHIB BALAK DAS | Contact No | 9477414225 |
| Address | 104 R B SARANI | Age | 40 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||