Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10302 | Date 15/12/2025 |
| Token No | SM/25-26/11959 15/12/2025 | Serial | 002 |
| Patient Name | Mrs. KAMALA SIL | Contact No | 9163781969 |
| Address | 65/7/4/A MAHESH JANNAGAR ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||