Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03759 | Date 15/02/2023 |
| Token No | SM/25-26/3690 18/06/2025 | Serial | 039 |
| Patient Name | Mr. PURUSATTAM SAMADDAR | Contact No | 9836707991 |
| Address | 22 BAHIR SERAMPORE SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||