Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10150 | Date 08/11/2025 |
| Token No | SM/25-26/10452 15/11/2025 | Serial | 031 |
| Patient Name | Mrs. GOURI MAJUMDAR | Contact No | 9007010268 |
| Address | 174 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||