Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09396 | Date 04/06/2025 |
| Token No | SM/25-26/2991 04/06/2025 | Serial | 014 |
| Patient Name | Mr. GORA BANIK | Contact No | 9836382959 |
| Address | 55A/1 WEST JANNAGAR ROAD SERAMPORE M 712203 | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||