Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04047 | Date 12/04/2023 |
| Token No | SM/25-26/5198 23/07/2025 | Serial | 039 |
| Patient Name | Miss PALAK DEY | Contact No | 7439903565 |
| Address | 55/A/12 B B GHOSH ROAD SERAMPORE 712203 | Age | 13 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||