Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04583 | Date 09/07/2021 |
| Token No | SM/25-26/2408 28/10/2025 | Serial | 005 |
| Patient Name | Mr. JITENDAR ROY | Contact No | 8013280906 |
| Address | 118 RAM SITA LANE,SERAMPORE | Age | 30 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||