Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02305 | Date 18/06/2019 |
| Token No | SM/24-25/17589 18/07/2024 | Serial | 031 |
| Patient Name | Mr. MADHUSUDAN DEY | Contact No | 9051026188 |
| Address | 26 THAKURBATI ST | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||