Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07926 | Date 09/12/2022 |
| Token No | SM/25-26/686 09/06/2025 | Serial | 002 |
| Patient Name | Mr. CHANDAN SAH | Contact No | 7890044628 |
| Address | 80/A/2 DEY STREET | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||