Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07770 | Date 29/08/2024 |
| Token No | SM/25-26/12524 30/12/2025 | Serial | 027 |
| Patient Name | Mr. BIJAY PASI | Contact No | 8921686715 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||