Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10183 | Date 15/11/2025 |
| Token No | SM/25-26/10499 15/11/2025 | Serial | 078 |
| Patient Name | Mr. PALASH PAUL | Contact No | 9088643911 |
| Address | GHOSHPARA DAKSHIN RAJYADHARPUR MALLICKPARA 712203 | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||