Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03364 | Date 09/12/2022 |
| Token No | SM/24-25/36744 10/03/2025 | Serial | 076 |
| Patient Name | Mrs. DHARAM SHILA DEVI | Contact No | |
| Address | 97/P/5 PRABASHNAGAR SERAMPORE 712249 | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||