Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06911 | Date 01/06/2024 |
| Token No | SM/25-26/2132 16/05/2025 | Serial | 025 |
| Patient Name | Mr. SK ASIF | Contact No | 8420413382 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 28 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/60 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||