Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09795 | Date 22/08/2025 |
| Token No | SM/25-26/6728 22/08/2025 | Serial | 006 |
| Patient Name | Mr. LAL KAMAL SANTRA | Contact No | 8670343116 |
| Address | 12/C TARAPUKUR COLONY SERAMPORE 712203 | Age | 27 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||