Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10108 | Date 29/10/2025 |
| Token No | SM/25-26/11460 04/12/2025 | Serial | 059 |
| Patient Name | Mrs. MANGALA DAS | Contact No | 9874317515 |
| Address | 65/25/58 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||