Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07771 | Date 30/08/2024 |
| Token No | SM/25-26/6520 18/08/2025 | Serial | 058 |
| Patient Name | Mrs. JYOTI DOM | Contact No | 8250185200 |
| Address | HARIJAN BASTI B B GHOSH ROAD SERAMPORE 712203 | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||