Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09843 | Date 30/08/2025 |
| Token No | SM/25-26/7149 30/08/2025 | Serial | 011 |
| Patient Name | Mr. SEKH NIJAMUDDIN | Contact No | |
| Address | 50 MALLICKPARA LANE SERAMPORE 712203 | Age | 56 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||