Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09846 | Date 30/08/2025 |
| Token No | SM/25-26/7178 30/08/2025 | Serial | 040 |
| Patient Name | Mr. KAJAL MAJUMDAR | Contact No | |
| Address | 55NO ROYLAND ROAD SERAMPORE 712201 | Age | 50 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||