Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09605 | Date 21/07/2025 |
| Token No | SM/25-26/5098 21/07/2025 | Serial | 081 |
| Patient Name | Mrs. SHANTI DAS | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||