Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05554 | Date 17/03/2022 |
| Token No | SM/25-26/2919 08/12/2025 | Serial | 014 |
| Patient Name | Mr. RUPOJIT ROY | Contact No | 8777281106 |
| Address | 20 jamidar bagan lane | Age | 21 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||