Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09359 | Date 29/05/2025 |
| Token No | SM/25-26/2735 29/05/2025 | Serial | 006 |
| Patient Name | Mr. SURJO DAS | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||