Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10159 | Date 10/11/2025 |
| Token No | SM/25-26/10262 10/11/2025 | Serial | 076 |
| Patient Name | Mrs. MITA DAS | Contact No | 6289241276 |
| Address | 8/A SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||