Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07621 | Date 08/08/2024 |
| Token No | SM/25-26/11172 29/11/2025 | Serial | 012 |
| Patient Name | Mr. GOURAB BHATTACHARJEE | Contact No | 8420037511 |
| Address | 30/F/1 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||