Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10175 | Date 15/11/2025 |
| Token No | SM/25-26/10443 15/11/2025 | Serial | 022 |
| Patient Name | Mr. SWAPAN PAL | Contact No | 7044439146 |
| Address | 22/24/F F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||