Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05266 | Date 10/01/2022 |
| Token No | SM/25-26/2648 17/11/2025 | Serial | 012 |
| Patient Name | Mr. SUJIT KUMAR BHAR | Contact No | 8282922414 |
| Address | 40 NABAKRISHNA GUIN LANE | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||