Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09175 | Date 25/04/2025 |
| Token No | SM/25-26/1179 25/04/2025 | Serial | 012 |
| Patient Name | Mr. PRADIP CHAKRABORTY | Contact No | 9007684315 |
| Address | C/122/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||