Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10181 | Date 15/11/2025 |
| Token No | SM/25-26/10496 15/11/2025 | Serial | 075 |
| Patient Name | Mrs. SWAPNA SHIULI | Contact No | 9163241725 |
| Address | 10A GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||