Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09759 | Date 14/08/2025 |
| Token No | SM/25-26/6423 14/08/2025 | Serial | 082 |
| Patient Name | Mr. AMIT DAS | Contact No | 7596834672 |
| Address | 10/O HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 37 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||