Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09209 | Date 05/05/2025 |
| Token No | SM/25-26/8867 09/10/2025 | Serial | 051 |
| Patient Name | Mr. SUKANTA MAN | Contact No | 8240549465 |
| Address | 3/2 D N MUKHERJEE ROAD MAIDYABATI M MALLICKPARA 712203 | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||