Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03926 | Date 13/03/2023 |
| Token No | SM/25-26/2073 15/05/2025 | Serial | 036 |
| Patient Name | Mrs. SANTANA CHATTERJEE | Contact No | 8777023919 |
| Address | 32/A PANCHANAN TALA LANE SERAMPORE 712201 | Age | 41 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||