Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10295 | Date 13/12/2025 |
| Token No | SM/25-26/12298 23/12/2025 | Serial | 003 |
| Patient Name | Mrs. RINA ROY | Contact No | 9609825888 |
| Address | 237 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 69 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||