Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 08622 | Date 29/01/2025 |
| Token No | SM/25-26/1063 23/04/2025 | Serial | 034 |
| Patient Name | Mrs. SAMPA DEY | Contact No | 9062649134 |
| Address | A/22/X TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||