Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07105 | Date 24/06/2024 |
| Token No | SM/25-26/11751 10/12/2025 | Serial | 010 |
| Patient Name | Mr. SK SOHAN | Contact No | 8697447524 |
| Address | 83 MALLICKPARA LANE SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||