Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 07163 | Date 27/06/2024 |
| Token No | SM/25-26/4990 19/07/2025 | Serial | 021 |
| Patient Name | Mr. PRINCE KUMAR YADAV | Contact No | 9903561733 |
| Address | 30/54/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||