Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10168 | Date 13/11/2025 |
| Token No | SM/25-26/11039 26/11/2025 | Serial | 033 |
| Patient Name | Mrs. BASANTI DEVI | Contact No | 7044764772 |
| Address | 55 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||