Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 11074 | Date 29/08/2026 |
| Token No | SM/25-26/20696 29/08/2026 | Serial | 005 |
| Patient Name | Mrs. SUSHILA SHAW | Contact No | 8100446678 |
| Address | 97/1/A PRAVASHNAGAR SERAMPORE 712249 | Age | 61 Years,7 Months,26 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||