Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13146 | Date 23/06/2025 |
| Token No | SM/25-26/936 23/06/2025 | Serial | 008 |
| Patient Name | Mr. BIJOY NAND RAM | Contact No | 6290114859 |
| Address | DEY GHAT LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||