Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13508 | Date 12/09/2025 |
| Token No | SM/25-26/2016 12/09/2025 | Serial | 002 |
| Patient Name | Mr. DIPAK KUMAR SEN | Contact No | 9051761114 |
| Address | 149 THAKURBATI STREET | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||