Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09778 | Date 20/08/2025 |
| Token No | SM/25-26/6596 20/08/2025 | Serial | 005 |
| Patient Name | Mrs. SHOBHA ROY | Contact No | |
| Address | PRAVASNAGAR SERAMPORE 712249 | Age | 81 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||