Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00934 | Date 12/02/2020 |
| Token No | SM/25-26/11919 13/12/2025 | Serial | 064 |
| Patient Name | Mrs. MOUMITA DOLUI | Contact No | 8296454513 |
| Address | 34/B/19 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 103/69 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||