Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 08275 | Date 25/11/2024 |
| Token No | SM/25-26/8445 24/09/2025 | Serial | 036 |
| Patient Name | Mr. GOPAL CHANDRA DEY | Contact No | 8622065379 |
| Address | 14A/1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||