Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10319 | Date 20/12/2025 |
| Token No | SM/25-26/12200 20/12/2025 | Serial | 040 |
| Patient Name | Master IVAN SIMON | Contact No | 8250979320 |
| Address | A/58/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 1 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||