Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08791 | Date 24/02/2025 |
| Token No | SM/25-26/10920 24/11/2025 | Serial | 021 |
| Patient Name | Mr. ASHOK KUMAR MAITY | Contact No | 9830330128 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||