Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09721 | Date 09/08/2025 |
| Token No | SM/25-26/8515 25/09/2025 | Serial | 020 |
| Patient Name | Mr. MADAN SAMANTA | Contact No | 8145468698 |
| Address | 266 NEW MAHESH SERAMPORE 712203 | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||