Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12905 | Date 23/04/2025 |
| Token No | SM/25-26/194 23/04/2025 | Serial | 005 |
| Patient Name | Mr. GOURTAM SARKAR | Contact No | 8420589460 |
| Address | 62/E BHAGIRATHI LANE | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||