Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04336 | Date 15/06/2023 |
| Token No | SM/25-26/3639 17/06/2025 | Serial | 019 |
| Patient Name | Mrs. SAMPA SARKAR | Contact No | 9874380848 |
| Address | 10/T DOCTOR BAGAN LANE SERAMPORE 712201 | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 81 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||