Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08704 | Date 10/02/2025 |
| Token No | SM/25-26/1755 08/05/2025 | Serial | 057 |
| Patient Name | Mrs. SAJANI DAS | Contact No | 9062992041 |
| Address | GHORAMARA MALLICKPARA SERAMPORE 712203 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||