Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09421 | Date 10/06/2025 |
| Token No | SM/25-26/3266 10/06/2025 | Serial | 004 |
| Patient Name | Mr. SAMIR BANIK | Contact No | 9432265510 |
| Address | 34/B/33 B B GHOSH ROAD SERAMPORE 712203 | Age | 43 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||