Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06292 | Date 17/02/2024 |
| Token No | SM/25-26/11757 10/12/2025 | Serial | 016 |
| Patient Name | Mr. MOHAMMAD KHAN | Contact No | 9331424558 |
| Address | 88/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 100/70 mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||