Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13893 | Date 23/12/2025 |
| Token No | SM/25-26/3094 23/12/2025 | Serial | 002 |
| Patient Name | Mr. SALIL KR BANERJEE | Contact No | 9477515392 |
| Address | 5C PITAMBAR DEY LANE | Age | 85 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||