Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13836 | Date 08/12/2025 |
| Token No | SM/25-26/2906 08/12/2025 | Serial | 001 |
| Patient Name | Mr. SIDDHESWAR SARKAR | Contact No | 9903035080 |
| Address | D C LANE | Age | 36 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||