Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04130 | Date 02/05/2023 |
| Token No | SM/24-25/35576 12/02/2025 | Serial | 008 |
| Patient Name | Mr. ROHAN BAG | Contact No | 8478816140 |
| Address | 12/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 7 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||