Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09360 | Date 29/05/2025 |
| Token No | SM/25-26/2758 29/05/2025 | Serial | 029 |
| Patient Name | Mrs. PURNIMA DAS | Contact No | 9748005678 |
| Address | 98/Y TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 64 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||