Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10063 | Date 15/10/2025 |
| Token No | SM/25-26/9159 15/10/2025 | Serial | 048 |
| Patient Name | Mr. RAMCHANDRA SHAW | Contact No | 9007184043 |
| Address | GHORAMARA MALLICKPARA 712203 | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||