Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00790 | Date 22/01/2020 |
| Token No | SM/25-26/12214 20/12/2025 | Serial | 054 |
| Patient Name | Mrs. SANTANA DAS | Contact No | 9831633614 |
| Address | 43/16/3 PRABASHNAGAR SERAMPORE 712249 | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 120/70 mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||