Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09575 | Date 16/07/2025 |
| Token No | SM/25-26/4784 16/07/2025 | Serial | 041 |
| Patient Name | Mr. MONOJ MISHRA | Contact No | 9874605411 |
| Address | 65/A/18 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 8 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||