Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13540 | Date 18/09/2025 |
| Token No | SM/25-26/2110 18/09/2025 | Serial | 033 |
| Patient Name | Mr. JEET PRAMANICK | Contact No | 8617292248 |
| Address | 41 NILMONI GHOSH LANE | Age | 24 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||