Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09452 | Date 16/06/2025 |
| Token No | SM/25-26/3549 16/06/2025 | Serial | 003 |
| Patient Name | Mrs. BASANTI ROY | Contact No | 9836989019 |
| Address | 83 RAJYADHARPUR GOVT COLONY SERAMPORE 712249 | Age | 76 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||