Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 05014 | Date 31/08/2023 |
| Token No | SM/25-26/4211 01/07/2025 | Serial | 026 |
| Patient Name | Miss SIRSHA SARKAR | Contact No | 9123735462 |
| Address | 65/20/9/1 MAHESH JANNAGAR ROAD SERAMPORE 712249 | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||