Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04556 | Date 20/07/2023 |
| Token No | SM/25-26/2104 15/05/2025 | Serial | 067 |
| Patient Name | Mrs. SAMPA DAS GHOSH | Contact No | 7596834595 |
| Address | 7/A SUKANTA LANE MALLICKPARA SERAMPORE 712203 | Age | 38 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||