Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12944 | Date 02/05/2025 |
| Token No | SM/25-26/325 02/05/2025 | Serial | 003 |
| Patient Name | Mr. JIBAN KOSTA | Contact No | 8100147058 |
| Address | 90 BLC MILLS ROAD | Age | 72 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||