Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12372 | Date 22/11/2024 |
| Token No | SM/25-26/2590 12/11/2025 | Serial | 017 |
| Patient Name | Mr. CHANDAN KANTI LAHA.. | Contact No | 8902901284 |
| Address | 77B J N LAHIRI ROAD | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||