Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 16097 | Date 25/09/2025 |
| Token No | SM/25-26/6529 25/09/2025 | Serial | 012 Last Visit: 25/09/2025 |
| Patient Name | Mr. SHIBAM MANNA | Contact No | |
| Address | SERAMPORE | Age | 23 Years,6 Months,21 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||