Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00564 | Date 17/12/2019 |
| Token No | SM/25-26/1801 09/05/2025 | Serial | 028 |
| Patient Name | Mr. AJIT DAS | Contact No | 9681931876 |
| Address | 34/B/47 SUKANTA PALLY PRABASHNAGAR SERAMPORE 712203 | Age | 75 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||