Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13077 | Date 05/06/2025 |
| Token No | SM/25-26/671 05/06/2025 | Serial | 011 |
| Patient Name | Mr. PROVAT DALAPATI | Contact No | 9748050809 |
| Address | 529/A G.T. ROAD, S.B. GHOSH LANE | Age | 54 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||