Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01140 | Date 07/03/2020 |
| Token No | SM/25-26/20651 27/08/2026 | Serial | 016 |
| Patient Name | Mrs. ANITA GUPTA | Contact No | 7890085109 |
| Address | 13/52 B B GHOSH ROAD SERAMPORE 712203 | Age | 35 Years,7 Months,25 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||