Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07562 | Date 01/08/2024 |
| Token No | SM/25-26/11023 26/11/2025 | Serial | 017 |
| Patient Name | Mr. SIDHARTHA GHOSH | Contact No | 9330166160 |
| Address | 99 KUMIR JALA ROAD MALLICKPARA SERAMPORE 712203 | Age | 27 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||