Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09377 | Date 02/06/2025 |
| Token No | SM/25-26/12593 31/12/2025 | Serial | 040 |
| Patient Name | Mr. ANSU SINGH | Contact No | 968149268 |
| Address | 145/X TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||