Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11783 | Date 12/07/2024 |
| Token No | SM/25-26/2156 22/09/2025 | Serial | 011 |
| Patient Name | Mr. SUBARNO KOLAY | Contact No | 7605829475 |
| Address | 39 S B GHOSH LANE | Age | 40 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||