Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08169 | Date 08/11/2024 |
| Token No | SM/24-25/35415 08/02/2025 | Serial | 052 |
| Patient Name | Mr. SK SELIM | Contact No | 8420287432 |
| Address | 91/D MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 150/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||