Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10154 | Date 10/11/2025 |
| Token No | SM/25-26/10205 10/11/2025 | Serial | 019 |
| Patient Name | Mr. KALYAN BALMIKI | Contact No | 9088680432 |
| Address | 97/F/3 PRAVASHNAGAR SERAMPORE 712249 | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||