Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01524 | Date 29/04/2020 |
| Token No | SM/25-26/5903 06/08/2025 | Serial | 021 |
| Patient Name | Mrs. GOURI SHUILI | Contact No | 8981540617 |
| Address | 3G D CRUZE GARDEN LANE SERAMPORE 712203 | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 140/80 mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||