Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13516 | Date 13/09/2025 |
| Token No | SM/25-26/2829 01/12/2025 | Serial | 013 |
| Patient Name | Mr. BIRENDRA MALBIYA | Contact No | 9433190052 |
| Address | 11/M S.B. GHOSH LANE | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||