Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07173 | Date 27/06/2024 |
| Token No | SM/25-26/5002 19/07/2025 | Serial | 033 |
| Patient Name | Mr. SARBADIP SIL | Contact No | 8902294988 |
| Address | DAKSHIN RAJYADHARPUR MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||