Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09612 | Date 23/07/2025 |
| Token No | SM/25-26/5181 23/07/2025 | Serial | 022 |
| Patient Name | Mr. AMAN SK | Contact No | 8927231658 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||