Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01327 | Date 01/04/2020 |
| Token No | SM/25-26/4402 05/07/2025 | Serial | 012 |
| Patient Name | Mr. MADHAB CHANDRA BANERJEE | Contact No | 8100277630 |
| Address | 34/B/13 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 54 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 80 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||