Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00104 | Date 13/09/2019 |
| Token No | SM/25-26/11910 13/12/2025 | Serial | 055 |
| Patient Name | Mrs. SHIBANI GHOSH | Contact No | 9804461714 |
| Address | 32/32A TARAPUKUR COLONY,SERAMPORE 712203 | Age | 82 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 130/80 mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||