Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02551 | Date 19/07/2019 |
| Token No | SM/25-26/1680 14/08/2025 | Serial | 012 |
| Patient Name | Mr. RAJKUMAR RAM | Contact No | 7003088080 |
| Address | 2 GOPAL GANGULY LANE | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||