Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10343 | Date 29/12/2025 |
| Token No | SM/25-26/12496 29/12/2025 | Serial | 065 |
| Patient Name | Mr. GANESH SHAW | Contact No | |
| Address | SERAMPORE | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||