Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09165 | Date 23/04/2025 |
| Token No | SM/25-26/1074 23/04/2025 | Serial | 045 |
| Patient Name | Mrs. MANIMALA GHOSH | Contact No | 8584948225 |
| Address | 134/2 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 67 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||