Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13166 | Date 26/06/2025 |
| Token No | SM/25-26/981 26/06/2025 | Serial | 001 |
| Patient Name | Mr. NILMONI DEY | Contact No | 7001898971 |
| Address | 627 G T ROAD | Age | 76 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||