Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07691 | Date 19/08/2024 |
| Token No | SM/25-26/11776 11/12/2025 | Serial | 003 |
| Patient Name | Miss DEBOPRIYA PATRA | Contact No | 9903315630 |
| Address | 19 SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||