Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05091 | Date 08/09/2023 |
| Token No | SM/25-26/10360 13/11/2025 | Serial | 029 |
| Patient Name | Mrs. SAROMA DAS | Contact No | 7044257179 |
| Address | 113 G T ROAD MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||