Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 11132 | Date 18/09/2026 |
| Token No | SM/25-26/22669 27/10/2026 | Serial | 005 |
| Patient Name | Mr. SHYAMAL KUMAR DEY | Contact No | 9331652527 |
| Address | D/145/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 54 Years,7 Months,24 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | 118/85 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||