Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10286 | Date 11/12/2025 |
| Token No | SM/25-26/11813 11/12/2025 | Serial | 040 |
| Patient Name | Mrs. MAYURI DUTTA GUPTA | Contact No | 9051623440 |
| Address | B/105/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||