Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04393 | Date 30/06/2023 |
| Token No | SM/25-26/10463 15/11/2025 | Serial | 042 |
| Patient Name | Mr. PLABON CHAKRABORTY | Contact No | 9088430844 |
| Address | 47/A SERAMPORE COLONY SERAMPORE M 712203 | Age | 10 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||