Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02457 | Date 13/08/2022 |
| Token No | SM/22-23/9001 20/05/2023 | Serial | 026 |
| Patient Name | Miss CHITRALEKHA GUPTA | Contact No | 7890085109 |
| Address | 13/52 B B GHOSH ROAD SARADA PALLY SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||