Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04139 | Date 04/05/2023 |
| Token No | SM/25-26/10491 15/11/2025 | Serial | 070 |
| Patient Name | Mr. NITAI CHANDRA DAS | Contact No | 9339009350 |
| Address | 65/20/13 M J ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/60 mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||