Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13871 | Date 16/12/2025 |
| Token No | SM/25-26/3002 16/12/2025 | Serial | 002 |
| Patient Name | Mr. PRABIR SRIMANI | Contact No | 9836488195 |
| Address | 6B BECHU DEY LANE | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||