Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10153 | Date 08/11/2025 |
| Token No | SM/25-26/10176 08/11/2025 | Serial | 071 |
| Patient Name | Mrs. SONALI DEY BARMAN | Contact No | 9163473985 |
| Address | 26 NEW MAHESH SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||