Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 13868 | Date 13/12/2025 |
| Token No | SM/25-26/2998 13/12/2025 | Serial | 014 |
| Patient Name | Mr. JAYANTA DASGUPTA | Contact No | 9433281512 |
| Address | 22K/4 FIRINGI DANGA ROAD | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||