Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03508 | Date 28/12/2022 |
| Token No | SM/25-26/12133 18/12/2025 | Serial | 046 |
| Patient Name | Mrs. SHANTI RANI RAY | Contact No | 9836689956 |
| Address | C/120/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 88 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||