Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03420 | Date 15/12/2022 |
| Token No | SM/25-26/11004 25/11/2025 | Serial | 033 |
| Patient Name | Mr. SACHIN KUMAR CHOWDHURY | Contact No | 9330281220 |
| Address | 56 RAYLAND ROAD SERAMPORE 712201 | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||