Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00306 | Date 25/10/2019 |
| Token No | SM/25-26/11013 26/11/2025 | Serial | 007 |
| Patient Name | Mrs. SWAPNA DEY | Contact No | 9007504561 |
| Address | GHORAMARA P PURBAPARA SERAMPORE 712203 | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||