Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03436 | Date 19/12/2022 |
| Token No | SM/25-26/1118 24/04/2025 | Serial | 019 |
| Patient Name | Mr. OM NATH ROY | Contact No | 8697613975 |
| Address | 55 NO ROY LAND ROAD SERAMPORE 712201 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||