Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00764 | Date 20/01/2020 |
| Token No | SM/25-26/15493 02/03/2026 | Serial | 069 |
| Patient Name | Mrs. SANDHYA DAS | Contact No | 9681931876 |
| Address | 34B/47 B B GHOSH ROAD SUKANTA PALLY 712203 | Age | 66 Years,2 Months,30 Days Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||