Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09295 | Date 15/05/2025 |
| Token No | SM/25-26/2051 15/05/2025 | Serial | 014 |
| Patient Name | Mr. UTTAM SARKAR | Contact No | 8820437731 |
| Address | PROMOD PALLY DAKSHIN RAJYADHARPUR MALLICKPARA SERAMPORE 712203 | Age | 43 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||