Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13906 | Date 31/12/2025 |
| Token No | SM/25-26/3124 31/12/2025 | Serial | 004 |
| Patient Name | Mr. BIJON CHATTERJEE | Contact No | 8478847547 |
| Address | 16 CHOWDHURY PARA LANE | Age | 85 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||