Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 07783 | Date 30/08/2024 |
| Token No | SM/25-26/12578 31/12/2025 | Serial | 025 |
| Patient Name | Mrs. RONAK KUMARI | Contact No | 8240169989 |
| Address | 1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||