Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08265 | Date 06/02/2023 |
| Token No | SM/25-26/2843 01/12/2025 | Serial | 027 |
| Patient Name | Mr. BROJOLAL DAS | Contact No | 9874521048 |
| Address | 20 R B SARANI | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||