Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08754 | Date 20/02/2025 |
| Token No | SM/24-25/35894 20/02/2025 | Serial | 002 |
| Patient Name | Mr. DEBASIS GORAI | Contact No | 8420720447 |
| Address | 22/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||