Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 07622 | Date 08/08/2024 |
| Token No | SM/25-26/11177 29/11/2025 | Serial | 017 |
| Patient Name | Mr. SHAMBHU GHOSH | Contact No | 8100143860 |
| Address | 55 ROYLAND ROAD SERAMPORE 712201 | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||