Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01649 | Date 23/05/2022 |
| Token No | SM/25-26/11020 26/11/2025 | Serial | 014 |
| Patient Name | Miss DEBLINA PALIT | Contact No | 9330453939 |
| Address | 10/F HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||