Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09691 | Date 04/08/2025 |
| Token No | SM/25-26/5821 04/08/2025 | Serial | 078 |
| Patient Name | Mr. MANGAL DAS | Contact No | 9748652234 |
| Address | 60/A GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 14 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||