Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02032 | Date 24/06/2022 |
| Token No | SM/25-26/11046 26/11/2025 | Serial | 040 |
| Patient Name | Mrs. GURIYA SHAW | Contact No | 6289281179 |
| Address | 34/B/23 B B GHOSH ROAD SUKANTA PALLY SERAMPORE HOOGHLY 712203 | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||