Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13785 | Date 27/11/2025 |
| Token No | SM/25-26/2788 27/11/2025 | Serial | 004 |
| Patient Name | Mr. DIPAK SHIL | Contact No | 9903997088 |
| Address | S B GHOSH LANE 2ND BYE LANE | Age | 55 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||