Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00804 | Date 25/01/2020 |
| Token No | SM/25-26/4069 28/06/2025 | Serial | 005 |
| Patient Name | Miss DISHA SHAW | Contact No | 8334073896 |
| Address | 65/25/9 MAHESH JAAN NAGAR ROAD SERAMPORE 712249 | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||