Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10248 | Date 29/11/2025 |
| Token No | SM/25-26/11422 04/12/2025 | Serial | 021 |
| Patient Name | Mrs. SUJATA KUMARI DAS | Contact No | 9007758885 |
| Address | 65/11 PRAVASHNAGAR SERAMPORE 712249 | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||