Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01459 | Date 20/04/2020 |
| Token No | SM/25-26/1787 09/05/2025 | Serial | 014 |
| Patient Name | Mrs. SUSMITA SANYAL | Contact No | 8420255668 |
| Address | 72A/3 PRABASHNAGAR PURBAPARA SERAMPORE 712249 | Age | 15 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||