Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13187 | Date 30/06/2025 |
| Token No | SM/25-26/1033 30/06/2025 | Serial | 018 |
| Patient Name | Mr. SUBHASIS SARKAR | Contact No | 8820848777 |
| Address | 9 DHULIPARA LANE | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||