Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05183 | Date 20/09/2023 |
| Token No | SM/25-26/8343 22/09/2025 | Serial | 050 |
| Patient Name | Mr. SOUMIK DAS | Contact No | 7044171640 |
| Address | C/126/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/50 mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||