Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09559 | Date 12/07/2025 |
| Token No | SM/25-26/4594 12/07/2025 | Serial | 015 |
| Patient Name | Mr. OM PRAKASH GUPTA | Contact No | 9007558279 |
| Address | 55/A/24 PRAVASHNAGAR SERAMPORE 712249 | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||