Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00930 | Date 12/02/2020 |
| Token No | SM/25-26/10700 20/11/2025 | Serial | 013 |
| Patient Name | Mr. AJAY KUMAR DAS | Contact No | 9123337803 |
| Address | 65/22/3 GURU GARDEN ROAD ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 77 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/95 mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||