Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03683 | Date 31/01/2023 |
| Token No | SM/25-26/5169 23/07/2025 | Serial | 010 |
| Patient Name | Mrs. PUNAM DEVI | Contact No | |
| Address | 12 RB SARANI SERAMPORE 712201 | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||