Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10204 | Date 22/11/2025 |
| Token No | SM/25-26/10828 22/11/2025 | Serial | 043 |
| Patient Name | Mrs. SHUKLA CHAUDHURI | Contact No | 6289777190 |
| Address | 73Y TARAPUKUR LANE GOVT QUARTER SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||