Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13686 | Date 03/11/2025 |
| Token No | SM/25-26/2469 03/11/2025 | Serial | 005 |
| Patient Name | Mr. MOLOY SAHA | Contact No | 8910783497 |
| Address | 16A/1 THAKURBATI STREET | Age | 43 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||