Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09974 | Date 18/09/2025 |
| Token No | SM/25-26/8137 18/09/2025 | Serial | 047 |
| Patient Name | Mr. SK SOHAN | Contact No | 7003832979 |
| Address | 28/F CHILEKHANA ROAD SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||