Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09681 | Date 01/08/2025 |
| Token No | SM/25-26/5786 04/08/2025 | Serial | 043 |
| Patient Name | Mrs. KABITA DOLUI | Contact No | 7449702258 |
| Address | 30/13 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||