Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00681 | Date 07/01/2020 |
| Token No | SM/25-26/2486 23/05/2025 | Serial | 017 |
| Patient Name | Mrs. ARPITA PAL | Contact No | 7998312048 |
| Address | 53X TARAPUKUR QUARTER SERAMPORE 712203 | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||