Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09791 | Date 21/08/2025 |
| Token No | SM/25-26/6699 21/08/2025 | Serial | 065 |
| Patient Name | Mr. MAHESH SHAW | Contact No | 6290261311 |
| Address | 123 TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||