Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00276 | Date 30/09/2019 |
| Token No | SM/25-26/10994 25/11/2025 | Serial | 023 |
| Patient Name | Mr. GOURAB GIRI | Contact No | 8981252245 |
| Address | 165 NEW MAHESH SERAMPORE 712203 | Age | 20 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||