Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03370 | Date 09/12/2022 |
| Token No | SM/25-26/11012 26/11/2025 | Serial | 006 |
| Patient Name | Mrs. LAXMI DAS | Contact No | 7439239649 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||