Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13460 | Date 03/09/2025 |
| Token No | SM/25-26/1870 03/09/2025 | Serial | 005 |
| Patient Name | Mr. BABULAL SEN | Contact No | 9831515561 |
| Address | 39D NIL MONI GHOSH LANE | Age | 72 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||