Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09639 | Date 25/07/2025 |
| Token No | SM/25-26/5346 25/07/2025 | Serial | 028 |
| Patient Name | Mrs. BASANA DEY | Contact No | 9903964768 |
| Address | 168/X TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||