Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07601 | Date 07/08/2024 |
| Token No | SM/25-26/11008 26/11/2025 | Serial | 002 |
| Patient Name | Miss SAGATA SETH | Contact No | 9883831015 |
| Address | 470 G T ROAD BOWBAZAR BAIDYABATI M CHATRA SERAMPORE 712204 | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||