Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08265 | Date 23/11/2024 |
| Token No | SM/25-26/2247 19/05/2025 | Serial | 055 |
| Patient Name | Mrs. JASMINA KHAN | Contact No | 9123045687 |
| Address | KATAPOL SERAMPORE 712202 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||