Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01360 | Date 06/04/2020 |
| Token No | SM/25-26/10063 07/11/2025 | Serial | 001 |
| Patient Name | Mr. SURAJ KUMAR SHAW | Contact No | 8697545926 |
| Address | 9/437 PRAVASHNAGAR SERAMPORE 712249 | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||