Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10309 | Date 17/12/2025 |
| Token No | SM/25-26/12073 17/12/2025 | Serial | 020 |
| Patient Name | Mrs. SWAGATA MALAKAR | Contact No | 9163565270 |
| Address | 45/4 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||