Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07262 | Date 17/10/2022 |
| Token No | SM/25-26/1082 03/07/2025 | Serial | 007 |
| Patient Name | Mr. KAMAL DALAL | Contact No | 9339622493 |
| Address | NILMONI GHOSH LANE | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||