Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 14817 | Date 29/08/2026 |
| Token No | SM/25-26/5620 29/08/2026 | Serial | 004 |
| Patient Name | Mr. RABIN MUKHERJEE | Contact No | 9088822836 |
| Address | 31B KAILASH CHATTERJEE LANE | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||