Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10170 | Date 14/11/2025 |
| Token No | SM/25-26/10574 17/11/2025 | Serial | 049 |
| Patient Name | Mr. PRAKASH KUMAR RAJBHAR | Contact No | 7439024306 |
| Address | 97/Q/2 GURUGARDEN ROAD SERAMPORE 712249 | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||