Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 13895 | Date 29/12/2025 |
| Token No | SM/25-26/3099 29/12/2025 | Serial | 005 |
| Patient Name | Mr. SUMAN GHOSH | Contact No | |
| Address | UPHC 2 CHATRA JOLTANK | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||