Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10141 | Date 25/08/2023 |
| Token No | SM/25-26/501 19/05/2025 | Serial | 014 |
| Patient Name | Mr. BISWANATH MONDAL | Contact No | NOT GIVEN |
| Address | 76 DEY STREET | Age | 81 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||