Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 13246 | Date 17/07/2025 |
| Token No | SM/25-26/1264 17/07/2025 | Serial | 010 |
| Patient Name | Mr. BAREN CHANDRA GAIN | Contact No | 9088723313 |
| Address | SERAMPORE RENTAL HOUSING ESTATE, 84 KHATIR NAZAR LANE | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||