Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10015 | Date 27/09/2025 |
| Token No | SM/25-26/8656 27/09/2025 | Serial | 026 |
| Patient Name | Mr. ASHIM GOSWAMI | Contact No | 6289533719 |
| Address | 30/41 TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||