Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 11759 | Date 08/07/2024 |
| Token No | SM/25-26/2816 29/11/2025 | Serial | 005 |
| Patient Name | Mr. SWAPNANIL DAS | Contact No | 7003410770 |
| Address | 3 BAISHNAB PARA 2ND LANE, MAHESH | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||