Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09250 | Date 08/05/2025 |
| Token No | SM/25-26/1732 08/05/2025 | Serial | 034 |
| Patient Name | Mr. GOPAL DAS | Contact No | 8272981740 |
| Address | 9/A/1 B B GHOSH ROAD SERAMPORE PRAVASHNAGAR 712249 | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||