Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13829 | Date 05/12/2025 |
| Token No | SM/25-26/2889 05/12/2025 | Serial | 003 |
| Patient Name | Mr. PRABHU MAHATO | Contact No | |
| Address | NAYA BAGAN INDIA JUTE MILL | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||