Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13764 | Date 22/11/2025 |
| Token No | SM/25-26/2711 22/11/2025 | Serial | 009 |
| Patient Name | Mr. SUKUMAR DAS.. | Contact No | 9978854611 |
| Address | 20 KHASBAGAN LANE (FLAT NO. 102) | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||