Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11793 | Date 15/07/2024 |
| Token No | SM/24-25/21075 22/02/2025 | Serial | 012 |
| Patient Name | Mr. SUSANTA KOLEY | Contact No | 9875555453 |
| Address | 39 S B GHOSH LANE | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||