Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09125 | Date 19/04/2025 |
| Token No | SM/25-26/868 19/04/2025 | Serial | 036 |
| Patient Name | Mr. SOURIK SAHA | Contact No | 9123603448 |
| Address | 1/29A 1NO RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||