Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12602 | Date 30/01/2025 |
| Token No | SM/25-26/2787 27/11/2025 | Serial | 003 |
| Patient Name | Mr. SUKANTA SIMLAI.. | Contact No | 9331072910 |
| Address | 166/A/1 THAKUR BATI STREET | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||