Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01307 | Date 30/03/2020 |
| Token No | SM/25-26/516 09/04/2025 | Serial | 101 |
| Patient Name | Mr. KANCHAN DAS | Contact No | 7998312048 |
| Address | 171 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 46 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||