Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12281 | Date 30/10/2024 |
| Token No | SM/24-25/19575 05/11/2024 | Serial | 005 |
| Patient Name | Mr. SURAJIT KOLAY | Contact No | 6289984064 |
| Address | 39 S B GHOSH LANE | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||