Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13181 | Date 30/06/2025 |
| Token No | SM/25-26/1024 30/06/2025 | Serial | 009 |
| Patient Name | Mr. SUJIT KUNDU | Contact No | 9903791304 |
| Address | 39/2 THAKURBATI STREET | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||