Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03744 | Date 13/02/2023 |
| Token No | SM/25-26/2418 22/05/2025 | Serial | 024 |
| Patient Name | Mr. SUJAN SINGH | Contact No | 9007866558 |
| Address | 70 NEW MAHESH SERAMPORE 712203 | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||