Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 05304 | Date 30/09/2023 |
| Token No | SM/25-26/10004 06/11/2025 | Serial | 001 |
| Patient Name | Miss SOMA DOLUI | Contact No | 7044155752 |
| Address | 38/A B B GHOSH ROAD SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||