Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10087 | Date 22/10/2025 |
| Token No | SM/25-26/9417 22/10/2025 | Serial | 008 |
| Patient Name | Mr. AJAY KUMAR JHA | Contact No | 8910159960 |
| Address | 97/P/14 PRABASHNAGAR SERAMPORE 712249 | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||