Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07465 | Date 18/07/2024 |
| Token No | SM/25-26/9499 24/10/2025 | Serial | 025 |
| Patient Name | Mr. RUPCHANDRA KAR | Contact No | 7890819850 |
| Address | GHORAMARA PASCHIMPARA SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||