Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04858 | Date 18/08/2023 |
| Token No | SM/25-26/5705 02/08/2025 | Serial | 019 |
| Patient Name | Mr. SOMNATH KOLEY | Contact No | 9330924523 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||