Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09711 | Date 08/08/2025 |
| Token No | SM/25-26/6065 08/08/2025 | Serial | 019 |
| Patient Name | Mr. ROHAN AMIN MONDAL | Contact No | 9564881998 |
| Address | MALLICKPARA LANE SERAMPORE 712203 | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||