Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 10270 | Date 06/12/2025 |
| Token No | SM/25-26/11537 06/12/2025 | Serial | 035 |
| Patient Name | Mrs. KRISHNA DAS | Contact No | 8240021778 |
| Address | 3/16 RAILAND CIRCULAR ROAD MAHESH SERAMPORE 712202 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||