Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04364 | Date 22/06/2023 |
| Token No | SM/25-26/11170 29/11/2025 | Serial | 010 |
| Patient Name | Mr. AMRIT KUMAR CHOUDHURI | Contact No | 8013551710 |
| Address | 56 ROYLAND ROAD SERAMPORE 712201 | Age | 25 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||