Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13427 | Date 29/08/2025 |
| Token No | SM/25-26/1787 29/08/2025 | Serial | 005 |
| Patient Name | Mr. SANDIP DAS DEY | Contact No | 8013295705 |
| Address | 14 KAILASH CHATTERJEE LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||