Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01095 | Date 27/02/2020 |
| Token No | SM/25-26/10733 20/11/2025 | Serial | 046 |
| Patient Name | Mr. PIYANSU DIKSHIT | Contact No | 7596824473 |
| Address | 32 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||