Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13614 | Date 14/10/2025 |
| Token No | SM/25-26/2283 14/10/2025 | Serial | 006 |
| Patient Name | Mr. JOYDEB CHAKRABORTY | Contact No | 9836836763 |
| Address | 106 N.N. COLONY | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||