Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10169 | Date 14/11/2025 |
| Token No | SM/25-26/11138 28/11/2025 | Serial | 027 |
| Patient Name | Mrs. PRATIMA BANIK | Contact No | 8697172208 |
| Address | 64 NEW MAHESH SERAMPORE 712203 | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||