Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09543 | Date 07/07/2025 |
| Token No | SM/25-26/4500 09/07/2025 | Serial | 023 |
| Patient Name | Miss DEBOLINA MAJUMDER | Contact No | 7003949567 |
| Address | FL NO 202 2ND FLOOR MAHADEB APARTMENT MALLICKPARA SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||