Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10201 | Date 21/11/2025 |
| Token No | SM/25-26/10766 21/11/2025 | Serial | 012 |
| Patient Name | Mr. SUMON MAJUMDAR | Contact No | 9007774189 |
| Address | 65/25/37 WEST JANNAGAR ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||