Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 07716 | Date 20/08/2024 |
| Token No | SM/25-26/12054 17/12/2025 | Serial | 001 |
| Patient Name | Mr. SUNIL KUMAR DAS | Contact No | 9523831445 |
| Address | 9/433/3/E PRAVASHNAGAR SERAMPORE 712249 | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||