Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10334 | Date 27/12/2025 |
| Token No | SM/25-26/12385 27/12/2025 | Serial | 005 |
| Patient Name | Mrs. PRATIMA SARDAR | Contact No | 7890729838 |
| Address | 27/E JANNAGAR ROAD SERAMPORE M 712202 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||