Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09982 | Date 19/09/2025 |
| Token No | SM/25-26/10915 24/11/2025 | Serial | 016 |
| Patient Name | Mr. BIMAL BANERJEE | Contact No | 9051744917 |
| Address | 23 T.P BHATTACHARYA STREET SERAMPORE 712203 | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||