Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13065 | Date 03/06/2025 |
| Token No | SM/25-26/630 03/06/2025 | Serial | 001 |
| Patient Name | Mr. DILIP SHAW | Contact No | 8651065632 |
| Address | 43 BHAGIRATHI LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||