Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09838 | Date 29/08/2025 |
| Token No | SM/25-26/7106 29/08/2025 | Serial | 022 |
| Patient Name | Mr. PRATAP SANKAR DAS | Contact No | 8013156326 |
| Address | 80 RISHI BANKIM SARANI SERAMPORE 712201 | Age | 68 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||