Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 14813 | Date 27/08/2026 |
| Token No | SM/25-26/5609 27/08/2026 | Serial | 015 |
| Patient Name | Mr. PINTU DAS | Contact No | 9477899536 |
| Address | BSNL OFFICE STAFF, 96 DEY STREET | Age | 57 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||