Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10328 | Date 23/12/2025 |
| Token No | SM/25-26/12340 23/12/2025 | Serial | 045 |
| Patient Name | Mrs. RINKU GOSWAMI MUKHERJEE | Contact No | 7439555168 |
| Address | 30/21 TARAPUKUR COLONY MALLICKPARA SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||