Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01721 | Date 27/05/2022 |
| Token No | SM/25-26/4101 30/06/2025 | Serial | 012 |
| Patient Name | Mrs. DOLI DAS | Contact No | 7980700157 |
| Address | 97/R/1 PRABASHNAGAR SERAMPORE 712249 | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||