Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 07140 | Date 26/06/2024 |
| Token No | SM/25-26/7193 01/09/2025 | Serial | 011 |
| Patient Name | Mr. ABHIJIT ROY | Contact No | 7501105331 |
| Address | 166/Y/D TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||