Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09514 | Date 30/06/2025 |
| Token No | SM/25-26/4153 30/06/2025 | Serial | 064 |
| Patient Name | Mr. SANJIB ROUTH | Contact No | 7687051495 |
| Address | 60/A 1NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 37 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||