Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00036 | Date 07/09/2019 |
| Token No | SM/25-26/6649 21/08/2025 | Serial | 015 |
| Patient Name | Mr. KOUSTAV DAS | Contact No | 8910565604 |
| Address | DINEN BHATTACHARYA SARANI PRABASHNAGAR SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||