Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06921 | Date 03/06/2024 |
| Token No | SM/25-26/6755 23/08/2025 | Serial | 006 |
| Patient Name | Mr. BIPUL KANTI DAS | Contact No | 9903915347 |
| Address | 14/A MALLICKPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 120/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||