Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 07774 | Date 30/08/2024 |
| Token No | SM/25-26/12556 31/12/2025 | Serial | 003 |
| Patient Name | Mr. BIKI RAM | Contact No | 8910039035 |
| Address | 101 PRAVASHNAGAR SERAMPORE 712249 | Age | 12 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||