Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04528 | Date 18/07/2023 |
| Token No | SM/25-26/10077 07/11/2025 | Serial | 015 |
| Patient Name | Mr. BANTY LAL RABIDAS | Contact No | 7890380097 |
| Address | PURBAPARA GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||