Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09321 | Date 19/05/2025 |
| Token No | SM/25-26/2267 19/05/2025 | Serial | 075 |
| Patient Name | Mrs. GITA RAJAK | Contact No | 9088763262 |
| Address | 97/H/2 PRAVASHNAGAR SERAMPORE 712249 | Age | 57 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||