Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03671 | Date 30/01/2023 |
| Token No | SM/25-26/6276 13/08/2025 | Serial | 013 |
| Patient Name | Mrs. DULALI SHAW | Contact No | 6290163167 |
| Address | 97/N/1 PRAVASHNAGAR SERAMPORE 712249 | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||