Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09757 | Date 14/08/2025 |
| Token No | SM/25-26/6410 14/08/2025 | Serial | 069 |
| Patient Name | Mr. SUNIL KUMAR SHAW | Contact No | 8388972155 |
| Address | 97/F PRAVASHNAGAR SERAMPORE 712249 | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||