Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04516 | Date 15/07/2023 |
| Token No | SM/25-26/11974 15/12/2025 | Serial | 017 |
| Patient Name | Mr. SAMIK CHATTERJEE | Contact No | 9674974019 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||