Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07764 | Date 29/08/2024 |
| Token No | SM/24-25/30544 04/11/2024 | Serial | 005 |
| Patient Name | Mrs. TAPATI MAJUMDAR | Contact No | 9903968503 |
| Address | 65/25/37 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 62 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||