Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09710 | Date 07/08/2025 |
| Token No | SM/25-26/6261 12/08/2025 | Serial | 037 |
| Patient Name | Mr. SHIBU KARMAKAR | Contact No | 9903645736 |
| Address | 21 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||