Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10068 | Date 16/10/2025 |
| Token No | SM/25-26/9214 16/10/2025 | Serial | 014 |
| Patient Name | Mr. NITAI MALI | Contact No | 8481878805 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 35 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||