Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10221 | Date 24/11/2025 |
| Token No | SM/25-26/12395 27/12/2025 | Serial | 015 |
| Patient Name | Mr. BABLU GOSWAMI | Contact No | 7449889461 |
| Address | TALPUKUR LOKENATH PALLY 712203 | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||