Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04519 | Date 17/07/2023 |
| Token No | SM/25-26/1728 08/05/2025 | Serial | 030 |
| Patient Name | Mr. BISWARUP MAJUMDER | Contact No | 9874277452 |
| Address | 9/371 B. B GHOSH ROAD 24 PALLY SERAMPORE M 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||