Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12710 | Date 03/03/2025 |
| Token No | SM/25-26/276 28/04/2025 | Serial | 004 |
| Patient Name | Mr. AMAR DAS | Contact No | 9051616719 |
| Address | 110 G.T. ROAD MANIKTALA | Age | 87 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||