Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06593 | Date 20/04/2024 |
| Token No | SM/25-26/4853 17/07/2025 | Serial | 030 |
| Patient Name | Mr. SK RAHIM | Contact No | 7439349132 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE712203 | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||