Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09574 | Date 16/07/2025 |
| Token No | SM/25-26/4775 16/07/2025 | Serial | 032 |
| Patient Name | Mrs. TAPATI DHAR | Contact No | 9804028268 |
| Address | 30/38 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||