Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09185 | Date 28/04/2025 |
| Token No | SM/25-26/1300 28/04/2025 | Serial | 044 |
| Patient Name | Mrs. KAMALA RAY | Contact No | |
| Address | 5 NO TARAPUKUR LANE SERAMPORE 712203 | Age | 76 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||