Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13210 | Date 07/07/2025 |
| Token No | SM/25-26/1106 07/07/2025 | Serial | 010 |
| Patient Name | Mr. DIPAK SIL | Contact No | 9903997088 |
| Address | SASHIBHUSAN GHOSH LANE, 2ND BYE LANE | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||