Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09934 | Date 11/09/2025 |
| Token No | SM/25-26/11668 08/12/2025 | Serial | 040 |
| Patient Name | Mrs. CHANDRABATI SHAW | Contact No | 7596973725 |
| Address | 39 S K NAGAR PRAVASHNAGAR SERAMPORE 712249 | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||