Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10247 | Date 29/11/2025 |
| Token No | SM/25-26/11241 29/11/2025 | Serial | 081 |
| Patient Name | Mr. SANTOSH DAS | Contact No | 7044171560 |
| Address | 8A/2/10 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||