Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13415 | Date 27/08/2025 |
| Token No | SM/25-26/2562 10/11/2025 | Serial | 014 |
| Patient Name | Mr. SHYAMAL SAHA | Contact No | 9681276468 |
| Address | 52/1B/1/B BHAGIRATHI LANE | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||