Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13011 | Date 21/05/2025 |
| Token No | SM/25-26/526 21/05/2025 | Serial | 011 |
| Patient Name | Mr. AVIJIT BANERJEE | Contact No | 9123008635 |
| Address | 66 DEY STREET | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||