Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09563 | Date 14/07/2025 |
| Token No | SM/25-26/4662 14/07/2025 | Serial | 022 |
| Patient Name | Mr. MD HARIJ | Contact No | 8515878410 |
| Address | PURBA NAJIRCHAK NASIBPUR BALAGACHI MURSHIDABAD | Age | 45 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||