Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10285 | Date 11/12/2025 |
| Token No | SM/25-26/11781 11/12/2025 | Serial | 008 |
| Patient Name | Mr. JAY DAS | Contact No | 8240341006 |
| Address | 34/B/34 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 39 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||