Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01458 | Date 20/04/2020 |
| Token No | SM/25-26/5540 30/07/2025 | Serial | 006 |
| Patient Name | Mrs. MOUMITA SANYAL | Contact No | 6290058519 |
| Address | 72A/3 PRABASHNAGAR PURBAPARA SERAMPORE 712249 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||