Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 05445 | Date 17/10/2023 |
| Token No | SM/25-26/6451 16/08/2025 | Serial | 019 |
| Patient Name | Miss JUNE CHAKRABORTY | Contact No | 9073123918 |
| Address | 31A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 37 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||