Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13679 | Date 31/10/2025 |
| Token No | SM/25-26/2458 31/10/2025 | Serial | 002 |
| Patient Name | Mr. NARAYAN CHANDRA KARMAKAR | Contact No | |
| Address | 56 AKHRA BATI LANE | Age | 75 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||