Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 08816 | Date 03/03/2025 |
| Token No | SM/24-25/36301 03/03/2025 | Serial | 009 |
| Patient Name | Mr. SIDDHARTH SINGH | Contact No | 7449505656 |
| Address | 12/E MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||