Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 13787 | Date 27/11/2025 |
| Token No | SM/25-26/2791 27/11/2025 | Serial | 007 |
| Patient Name | Mr. SOUGATA NAG | Contact No | 9903672822 |
| Address | 3/A KHATIR BAZAR LANE | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||