Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02560 | Date 25/08/2022 |
| Token No | SM/25-26/10626 18/11/2025 | Serial | 025 |
| Patient Name | Mr. SHYAMSUNDAR DAS | Contact No | 9874112150 |
| Address | DAKSHIN MONDAL PARA SIMLA 712203 | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||