Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07596 | Date 06/08/2024 |
| Token No | SM/25-26/10989 25/11/2025 | Serial | 018 |
| Patient Name | Mr. SURAJ DAS | Contact No | 9051754536 |
| Address | B B GHOSH ROAD SOCIETY MATH SERAMPORE 712203 | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||