Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03303 | Date 01/12/2022 |
| Token No | SM/24-25/30445 31/10/2024 | Serial | 014 |
| Patient Name | Mrs. RINKU BANIK DAS | Contact No | 9874642573 |
| Address | 43/32/D/2 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 37 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||