Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00613 | Date 26/12/2019 |
| Token No | SM/25-26/7011 28/08/2025 | Serial | 020 |
| Patient Name | Mr. AJOY BHUIYAN | Contact No | 9330376978 |
| Address | JITEN LAHIRI ROAD SERAMPORE 712202 | Age | 25 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||