Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08422 | Date 22/02/2023 |
| Token No | SM/25-26/1341 23/07/2025 | Serial | 014 |
| Patient Name | Mr. GOPAL GHOSH | Contact No | 9339372572 |
| Address | 298(109) G.T. ROAD, BAIDYABATI (M) | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||