Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13095 | Date 11/06/2025 |
| Token No | SM/25-26/743 11/06/2025 | Serial | 006 |
| Patient Name | Mr. KANCHAN CHAKRABORTY | Contact No | 8478822435 |
| Address | 2/A GOPAL GANGULY LANE | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||