Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10123 | Date 24/08/2023 |
| Token No | SM/25-26/1865 02/09/2025 | Serial | 017 |
| Patient Name | Mr. BISWAJIT DUTTA | Contact No | 9681249029 |
| Address | 43 DHULIPARA LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||