Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09678 | Date 31/07/2025 |
| Token No | SM/25-26/5626 31/07/2025 | Serial | 027 |
| Patient Name | Mrs. GITIKA SUR | Contact No | 8585894056 |
| Address | 43/A/1 G T ROAD WEST MALLICKPARA SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||