Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 05773 | Date 01/12/2023 |
| Token No | SM/25-26/43 02/04/2025 | Serial | 014 |
| Patient Name | Mr. SANDIP MONDAL | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||