Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00552 | Date 13/12/2019 |
| Token No | SM/25-26/11687 08/12/2025 | Serial | 059 |
| Patient Name | Mrs. RENU BANIK | Contact No | 8100317225 |
| Address | D/158/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 76 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/70 mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||