Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09763 | Date 16/08/2025 |
| Token No | SM/25-26/6443 16/08/2025 | Serial | 011 |
| Patient Name | Mr. AJAY BANIK | Contact No | 7044784329 |
| Address | 47/I PRAVASHNAGAR SERAMPORE 712249 | Age | 54 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||