Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 10310 | Date 18/12/2025 |
| Token No | SM/25-26/12091 18/12/2025 | Serial | 004 |
| Patient Name | Mr. TARAK KARMAKAR | Contact No | 9339387094 |
| Address | 65/A F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 63 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||