Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04629 | Date 27/07/2023 |
| Token No | SM/25-26/6723 22/08/2025 | Serial | 001 |
| Patient Name | Mr. RUDRA SAHA | Contact No | 8479834976 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||