Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12983 | Date 14/05/2025 |
| Token No | SM/25-26/440 14/05/2025 | Serial | 001 |
| Patient Name | Mr. NARAYAN CHANDRA DAS | Contact No | 9330805554 |
| Address | 30 NEHERU NAGAR COLONY | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||