Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 10109 | Date 29/10/2025 |
| Token No | SM/25-26/9892 03/11/2025 | Serial | 065 |
| Patient Name | Mr. RAJU GHOSH | Contact No | 9874748639 |
| Address | 218 53/E GHOSAL PARA NABAGRAM BAIDYABATI 712203 | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||