Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09176 | Date 26/04/2025 |
| Token No | SM/25-26/1219 26/04/2025 | Serial | 004 |
| Patient Name | Mr. VAJARAM DAS | Contact No | 8420205994 |
| Address | UTTAR MONDAL PARA SIMLA SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||