Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 13562 | Date 22/09/2025 |
| Token No | SM/25-26/2159 22/09/2025 | Serial | 014 |
| Patient Name | Mr. PRADIP MAJUMDER | Contact No | 8420722078 |
| Address | 1/339 MAHESH COLONY | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||