Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11522 | Date 13/05/2024 |
| Token No | SM/25-26/1622 11/08/2025 | Serial | 015 |
| Patient Name | Mr. ALOKE HALDER | Contact No | 9830201795 |
| Address | THAKURBATI STREET | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||