Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11706 | Date 26/06/2024 |
| Token No | SM/25-26/2758 25/11/2025 | Serial | 011 |
| Patient Name | Mr. SAMARENDU KUNDU | Contact No | 9748461778 |
| Address | 33 PANDIT KALINATH BHATTACHARJEE STREET | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||