Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07702 | Date 20/08/2024 |
| Token No | SM/25-26/4555 11/07/2025 | Serial | 010 |
| Patient Name | Mr. SOHAN SHAW | Contact No | 8961624227 |
| Address | B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||