Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06864 | Date 27/05/2024 |
| Token No | SM/25-26/10888 22/11/2025 | Serial | 103 |
| Patient Name | Mr. SUBHAYAN CHATTERJEE | Contact No | 9330360736 |
| Address | 14/B SATISH CHANDRA GHOSH LANE SERAMPORE 712202 | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||