Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07165 | Date 27/06/2024 |
| Token No | SM/25-26/4996 19/07/2025 | Serial | 027 |
| Patient Name | Mr. SRIKANT KUMAR SHAW | Contact No | 6289853671 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 20 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||