Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09485 | Date 20/06/2025 |
| Token No | SM/25-26/3770 20/06/2025 | Serial | 018 |
| Patient Name | Mrs. PIYALI SIL | Contact No | 9674511785 |
| Address | 165 M J ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||