Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00442 | Date 25/11/2019 |
| Token No | SM/25-26/4124 30/06/2025 | Serial | 035 |
| Patient Name | Mrs. ISHA SAHA | Contact No | 8017328621 |
| Address | 34/B/54 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||