Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04140 | Date 05/03/2021 |
| Token No | SM/25-26/2695 20/11/2025 | Serial | 009 |
| Patient Name | Mr. SWAPAN BANERJEE | Contact No | 9477997572 |
| Address | 66 THAKUR BATI STREET | Age | 75 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||