Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04329 | Date 15/06/2023 |
| Token No | SM/25-26/5894 06/08/2025 | Serial | 012 |
| Patient Name | Mr. SANKAR SAHA | Contact No | 9432228387 |
| Address | 22/T/1 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 140/70 mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||