Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01269 | Date 24/03/2020 |
| Token No | SM/25-26/4920 18/07/2025 | Serial | 001 |
| Patient Name | Mrs. PINKI NAG | Contact No | 8240714442 |
| Address | 30/66 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 42 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||