Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 07145 | Date 26/06/2024 |
| Token No | SM/25-26/4939 18/07/2025 | Serial | 020 |
| Patient Name | Miss SOHANA DAS | Contact No | 8910599864 |
| Address | 13A/3 K L GOSWAMI SARANI SERAMPORE 712201 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||