Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 08645 | Date 31/01/2025 |
| Token No | SM/24-25/34972 31/01/2025 | Serial | 051 |
| Patient Name | Mrs. SAMPA GHOSH GOSWAMI | Contact No | 8013357012 |
| Address | 138/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||