Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11870 | Date 31/07/2024 |
| Token No | SM/25-26/1527 05/08/2025 | Serial | 001 |
| Patient Name | Mr. RANJIT CHOUDHURY | Contact No | 9239941018 |
| Address | 55 RAY LAND ROAD | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||