Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10056 | Date 13/10/2025 |
| Token No | SM/25-26/9061 13/10/2025 | Serial | 064 |
| Patient Name | Mr. SUMIT SIL | Contact No | 8100501735 |
| Address | 193 RAJYADHARPUR GOVT COLONY MALLICKPARA SERAMPORE 712203 | Age | 20 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||