Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10171 | Date 14/11/2025 |
| Token No | SM/25-26/11942 13/12/2025 | Serial | 087 |
| Patient Name | Mrs. SOMA CHAKRABORTY | Contact No | 9775852243 |
| Address | 221/2 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||