Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04214 | Date 23/05/2023 |
| Token No | SM/25-26/4489 09/07/2025 | Serial | 012 |
| Patient Name | Mr. TUHIN GHOSH | Contact No | 8697353211 |
| Address | 65/A/1/A F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 17 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||