Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 09758 | Date 14/08/2025 |
| Token No | SM/25-26/6420 14/08/2025 | Serial | 079 |
| Patient Name | Mrs. PUJA PAL CHANDA | Contact No | 8420925488 |
| Address | 31 GANGULY BAGAN LANE SERAMPORE 712202 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||