Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02130 | Date 04/07/2022 |
| Token No | SM/25-26/11169 29/11/2025 | Serial | 009 |
| Patient Name | Mr. SUDHIR CHANDRA SAHA | Contact No | 9038934478 |
| Address | 54 MALLICKPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||