Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10301 | Date 13/12/2025 |
| Token No | SM/25-26/11950 13/12/2025 | Serial | 095 |
| Patient Name | Mr. DEBABBRITO NAG | Contact No | 8240714442 |
| Address | 30/66 TARAPUKUR LANE SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||