Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03982 | Date 25/03/2023 |
| Token No | SM/25-26/8004 15/09/2025 | Serial | 020 |
| Patient Name | Mr. DILIP NAYEK | Contact No | 9883104501 |
| Address | 3/1 D CRUZE GARDEN LANE SERAMPORE 712203 | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||