Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 07053 | Date 20/06/2024 |
| Token No | SM/25-26/5046 21/07/2025 | Serial | 029 |
| Patient Name | Mr. KESHAB CH. SARKAR | Contact No | 9874380848 |
| Address | 10/T DOCTOR BAGAN LANE MALLICKPARA SERAMPORE 712203 | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||