Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13885 | Date 20/12/2025 |
| Token No | SM/25-26/3057 20/12/2025 | Serial | 004 |
| Patient Name | Mr. INDRAJIT KOLEY | Contact No | 8910011525 |
| Address | 38B S.B. GHOSH LANE | Age | 43 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||