Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09164 | Date 23/04/2025 |
| Token No | SM/25-26/1068 23/04/2025 | Serial | 039 |
| Patient Name | Mrs. RIMA CHAKRABORTY | Contact No | 7439558687 |
| Address | 212/A RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||