Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02626 | Date 05/09/2022 |
| Token No | SM/25-26/1394 30/04/2025 | Serial | 019 |
| Patient Name | Mr. DEBRAJ BANIK | Contact No | 8335977022 |
| Address | 24/D TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 9 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||