Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 10420 | Date 16/09/2023 |
| Token No | SM/25-26/1785 29/08/2025 | Serial | 003 |
| Patient Name | Mr. RANAJIT DEY | Contact No | 7001898971 |
| Address | 627 GT ROAD | Age | 39 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||