Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09617 | Date 13/07/2023 |
| Token No | SM/25-26/670 05/06/2025 | Serial | 010 |
| Patient Name | Mr. ASHIM KUMAR DAS | Contact No | 9830156248 |
| Address | 54 DHULIPARA LANE | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||