Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01693 | Date 27/05/2022 |
| Token No | SM/25-26/12387 27/12/2025 | Serial | 007 |
| Patient Name | Mr. SURESH PRASAD SHAW | Contact No | 6291168299 |
| Address | 9/1/A/104 M J ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||