Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10320 | Date 20/12/2025 |
| Token No | SM/25-26/12205 20/12/2025 | Serial | 045 |
| Patient Name | Mr. SUMANA MITRA | Contact No | 9051587831 |
| Address | 16 A/6 BARA BAGAN LANE SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||