Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07033 | Date 18/06/2024 |
| Token No | SM/25-26/9307 17/10/2025 | Serial | 009 |
| Patient Name | Mr. RAHUL DAS | Contact No | 9062273297 |
| Address | 20 BAZAR BYE LANE 712201 | Age | 25 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||