Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10157 | Date 10/11/2025 |
| Token No | SM/25-26/10252 10/11/2025 | Serial | 066 |
| Patient Name | Mr. SOIEB MUFTI | Contact No | 8420120562 |
| Address | 3/A CHILEKHANA ROAD MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||