Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09581 | Date 17/07/2025 |
| Token No | SM/25-26/4838 17/07/2025 | Serial | 015 |
| Patient Name | Mrs. RAJESHWARY DOLUI | Contact No | 8420345143 |
| Address | 3 D N BHATTACHARYA SARANI SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||