Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10072 | Date 16/10/2025 |
| Token No | SM/25-26/9257 16/10/2025 | Serial | 057 |
| Patient Name | Mr. MANIK CHANDRA DUTTA | Contact No | 9007631835 |
| Address | 43/B/A GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 54 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||