Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03560 | Date 06/12/2019 |
| Token No | SM/25-26/2755 25/11/2025 | Serial | 008 |
| Patient Name | Mr. GOUTAM NANDI | Contact No | 6291374488 |
| Address | 5/A L M BHATTACHARJEE STREET | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||