Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05305 | Date 30/09/2023 |
| Token No | SM/25-26/7564 06/09/2025 | Serial | 027 |
| Patient Name | Mr. SURAJIT HAZRA | Contact No | 9734823157 |
| Address | BALARAMPUR HATI PURSURAH 712415 | Age | 30 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||