Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09528 | Date 02/07/2025 |
| Token No | SM/25-26/4290 02/07/2025 | Serial | 070 |
| Patient Name | Mrs. LAKSHIMANI SHAW | Contact No | 9681620726 |
| Address | 8/B HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 79 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||