Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03097 | Date 09/11/2022 |
| Token No | SM/25-26/9769 31/10/2025 | Serial | 064 |
| Patient Name | Mr. GAUTAM DAS | Contact No | 9681931876 |
| Address | 34/B/47 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 44 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||