Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03513 | Date 28/12/2022 |
| Token No | SM/25-26/5371 26/07/2025 | Serial | 003 |
| Patient Name | Mr. SHAMBHU NATH CHAKRABORTY | Contact No | 9007228676 |
| Address | 43/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 61 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 140/80 mmHg | Weight | 76 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||