Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 13841 | Date 08/12/2025 |
| Token No | SM/25-26/2922 08/12/2025 | Serial | 017 |
| Patient Name | Mr. DIPAK DAS | Contact No | 9097661029 |
| Address | 4 D N MUKHERJEE LANE | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||