Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09103 | Date 16/04/2025 |
| Token No | SM/25-26/688 16/04/2025 | Serial | 003 |
| Patient Name | Mr. MANAV MANDAL | Contact No | 6291817045 |
| Address | 25/A SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||