Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10272 | Date 06/12/2025 |
| Token No | SM/25-26/11891 13/12/2025 | Serial | 036 |
| Patient Name | Mrs. SUSHMITA DAS | Contact No | 9875598389 |
| Address | 47A RAILAND ROAD KALITALA SERAMPORE 712202 | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||