Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05348 | Date 06/10/2023 |
| Token No | SM/25-26/7118 29/08/2025 | Serial | 034 |
| Patient Name | Mr. SONU LAL DAS | Contact No | 8271573148 |
| Address | GHORAMARA PURBAPARA SERAMORE 712203 | Age | 23 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||