Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10295 | Date 04/09/2023 |
| Token No | SM/25-26/782 12/06/2025 | Serial | 007 |
| Patient Name | Mr. SANDIP GIRI | Contact No | 6291930998 |
| Address | 17C N L BHATTACHARJEE STREET | Age | 22 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||