Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13159 | Date 25/06/2025 |
| Token No | SM/25-26/973 25/06/2025 | Serial | 027 |
| Patient Name | Mr. MRINAL DEY | Contact No | 7890323229 |
| Address | 5/C/1 DEY STREET | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||