Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09767 | Date 18/08/2025 |
| Token No | SM/25-26/6471 18/08/2025 | Serial | 009 |
| Patient Name | Mr. MOHAMMED SUFYAN | Contact No | 9831513550 |
| Address | 106 G T ROAD WEST MALLICKPARA SERAMPORE 712203 | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||