Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07177 | Date 27/06/2024 |
| Token No | SM/25-26/5139 22/07/2025 | Serial | 027 |
| Patient Name | Mrs. SUNITA GHOSH | Contact No | 7003612191 |
| Address | 13/B SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||