Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10303 | Date 15/12/2025 |
| Token No | SM/25-26/11975 15/12/2025 | Serial | 018 |
| Patient Name | Mrs. PRIYANKA DEB DEY | Contact No | 8777453710 |
| Address | 61/2 WEST G T ROAD MALLICKPARA SERAMPORE 712203 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||