Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10305 | Date 16/12/2025 |
| Token No | SM/25-26/12039 16/12/2025 | Serial | 039 |
| Patient Name | Mr. SAILEN CHATTERJEE | Contact No | 8335861644 |
| Address | 99Y TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||