Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 07133 | Date 26/06/2024 |
| Token No | SM/25-26/9679 30/10/2025 | Serial | 036 |
| Patient Name | Mr. SK MARUF | Contact No | 8961248491 |
| Address | 23 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||