Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10307 | Date 16/12/2025 |
| Token No | SM/25-26/12051 16/12/2025 | Serial | 051 |
| Patient Name | Mrs. JYOTI GUPTA | Contact No | 9330161196 |
| Address | 63 3RD FLOOR 301 KESHAB CHANDRA SEN STREET KOLKATA 700009 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||