Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10227 | Date 27/11/2025 |
| Token No | SM/25-26/11077 27/11/2025 | Serial | 030 |
| Patient Name | Mr. SURAJIT DAS | Contact No | 6290258199 |
| Address | 37 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||