Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01639 | Date 23/05/2022 |
| Token No | SM/25-26/5563 30/07/2025 | Serial | 029 |
| Patient Name | Mr. NEMAI SAMANTA | Contact No | 9163079218 |
| Address | 6/A B B GHOSH ROAD MALLICKPARA SERAMPORE 712203 | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||