Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00750 | Date 17/01/2020 |
| Token No | SM/25-26/20673 27/08/2026 | Serial | 038 |
| Patient Name | Mrs. JOLLY CHAKRABORTY | Contact No | 7044765580 |
| Address | 32/D TARAPUKUR LANE SERAMPORE 712203 | Age | 49 Years,5 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | 126/77 mmHg | Weight | 72 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||