Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04419 | Date 03/07/2023 |
| Token No | SM/25-26/10599 17/11/2025 | Serial | 074 |
| Patient Name | Mr. SISIR DAS | Contact No | 7439824108 |
| Address | 7/A SANIPARA BYE LANE MALLICKPARA SERAMPORE 712203 | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 138/70 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||