Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10329 | Date 24/12/2025 |
| Token No | SM/25-26/12346 24/12/2025 | Serial | 002 |
| Patient Name | Mr. SAILEN NAG | Contact No | 9007519779 |
| Address | A/39/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||