Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 09619 | Date 23/07/2025 |
| Token No | SM/25-26/5197 23/07/2025 | Serial | 038 |
| Patient Name | Mr. SUMAN SARKAR | Contact No | 7595897174 |
| Address | 65/A/1 S C CHATTERJEE SARANI MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||