Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10284 | Date 10/12/2025 |
| Token No | SM/25-26/11759 10/12/2025 | Serial | 018 |
| Patient Name | Mr. SWAPAN CHAKRABORTY | Contact No | 8420366515 |
| Address | 47/A 5 NO COLONY SERAMPORE 712203 | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||