Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 11995 | Date 22/08/2024 |
| Token No | SM/25-26/2923 08/12/2025 | Serial | 018 |
| Patient Name | Mr. JAY RAM PRASAD | Contact No | 9123971541 |
| Address | 4 D N MUKHERJEE LANE | Age | 42 yrs Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||