Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00317 | Date 01/11/2019 |
| Token No | SM/25-26/11909 13/12/2025 | Serial | 054 |
| Patient Name | Mrs. REBA DAS | Contact No | 9330817046 |
| Address | 8/A/2 PRABASHNAGAR SERAMPORE 712249 | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 113/57 mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||