Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06811 | Date 16/05/2024 |
| Token No | SM/25-26/5314 24/07/2025 | Serial | 052 |
| Patient Name | Master SREEJIT SADHUKHAN | Contact No | 9775763511 |
| Address | DAIPUKUR PANDUA 712149 | Age | 5 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||