Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13691 | Date 03/11/2025 |
| Token No | SM/25-26/2476 03/11/2025 | Serial | 012 |
| Patient Name | Mr. TARAK CHANDRA KUNDU | Contact No | |
| Address | 46 KHASBAGAN LANE | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||