Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09098 | Date 11/04/2025 |
| Token No | SM/25-26/619 11/04/2025 | Serial | 031 |
| Patient Name | Mr. SURAJIT ROJA | Contact No | 9735359968 |
| Address | HETAMCHAK AGRI SERAMPORE 712401 | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||