Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00950 | Date 14/02/2020 |
| Token No | SM/25-26/12330 23/12/2025 | Serial | 035 |
| Patient Name | Mr. SANJAY KUMAR PAL | Contact No | 9123013641 |
| Address | 2/C TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||