Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09404 | Date 05/06/2025 |
| Token No | SM/25-26/3056 05/06/2025 | Serial | 014 |
| Patient Name | Mrs. CHITRALI BAGCHI NAYEK | Contact No | 8617213227 |
| Address | 11/H/A PRAVASHNAGAR SERAMPORE 712249 | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||