Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10347 | Date 30/12/2025 |
| Token No | SM/25-26/12541 30/12/2025 | Serial | 044 |
| Patient Name | Mrs. RUPA BARMAN | Contact No | 6294366679 |
| Address | 205 MAHADEB APARTMENT 85 KUMIR JALA ROAD MALLICKPARA SERAMPORE 712203 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||