Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10341 | Date 29/12/2025 |
| Token No | SM/25-26/12483 29/12/2025 | Serial | 052 |
| Patient Name | Mrs. SHANTI DAS | Contact No | 7890994884 |
| Address | 65/7/7B GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||