Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09134 | Date 21/04/2025 |
| Token No | SM/25-26/1259 28/04/2025 | Serial | 003 |
| Patient Name | Mr. SEKH SABIR ALI | Contact No | 9903257528 |
| Address | 36/O MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||