Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 15007 | Date 28/10/2026 |
| Token No | SM/25-26/6113 28/10/2026 | Serial | 033 |
| Patient Name | Mr. TAPAS CHATTERJEE | Contact No | 8910942982 |
| Address | 629 G.T. ROAD | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||