Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07672 | Date 14/08/2024 |
| Token No | SM/25-26/11778 11/12/2025 | Serial | 005 |
| Patient Name | Mr. SAWAGATO SINHA | Contact No | 8981330626 |
| Address | 39/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||