Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03655 | Date 28/01/2023 |
| Token No | SM/25-26/11844 12/12/2025 | Serial | 006 |
| Patient Name | Mrs. BABY DOLUI | Contact No | 7890566112 |
| Address | 98/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 42 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||