Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05333 | Date 04/10/2023 |
| Token No | SM/25-26/7629 08/09/2025 | Serial | 059 |
| Patient Name | Master RAJIB NAYEK | Contact No | 9330034695 |
| Address | 174/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 5 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 10 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||