Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04730 | Date 05/08/2023 |
| Token No | SM/25-26/12218 20/12/2025 | Serial | 058 |
| Patient Name | Mr. ROHAN SHARMA | Contact No | 6290761489 |
| Address | A/6/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||