Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09460 | Date 16/06/2025 |
| Token No | SM/25-26/3594 16/06/2025 | Serial | 048 |
| Patient Name | Mr. SACHIN SHAW | Contact No | 9155320780 |
| Address | 165 NEW MAHESH SERAMPORE 712203 | Age | 25 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||