Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00202 | Date 20/09/2019 |
| Token No | SM/25-26/4004 26/06/2025 | Serial | 024 |
| Patient Name | Mrs. SAMAPTI KANTI | Contact No | 9088993394 |
| Address | 9/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||