Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09821 | Date 27/08/2025 |
| Token No | SM/25-26/6973 27/08/2025 | Serial | 047 |
| Patient Name | Mr. HARADHAN GHOSH | Contact No | 7439257305 |
| Address | 4 NO MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||