Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09146 | Date 21/04/2025 |
| Token No | SM/25-26/979 21/04/2025 | Serial | 074 |
| Patient Name | Mr. MADON MOHAN HAZRA | Contact No | 9330828891 |
| Address | 29 SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||