Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05338 | Date 05/10/2023 |
| Token No | SM/25-26/12128 18/12/2025 | Serial | 041 |
| Patient Name | Mr. BISWANATH GOSWAMI | Contact No | 7439659236 |
| Address | 65 MALLICKPARA LANE SERAMPORE 712203 | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||