Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00764 | Date 20/01/2020 |
| Token No | SM/25-26/5528 29/07/2025 | Serial | 026 |
| Patient Name | Mrs. SANDHYA DAS | Contact No | 9681931876 |
| Address | 34B/47 B B GHOSH ROAD SUKANTA PALLY 712203 | Age | 65 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||