Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00156 | Date 16/09/2019 |
| Token No | SM/25-26/4632 12/07/2025 | Serial | 053 |
| Patient Name | Mrs. JHUMA ADAK | Contact No | 8961046779 |
| Address | 59A/1 MALLICKPARA LANE SERAMPORE 712203 | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||