Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09633 | Date 24/07/2025 |
| Token No | SM/25-26/6640 21/08/2025 | Serial | 006 |
| Patient Name | Mr. AYUSH CHAKRABORTY | Contact No | 9163076293 |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 11 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||