Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07703 | Date 20/08/2024 |
| Token No | SM/25-26/11960 15/12/2025 | Serial | 003 |
| Patient Name | Mr. SURAJ SHAW | Contact No | 8961624227 |
| Address | B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||