Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03750 | Date 13/02/2023 |
| Token No | SM/25-26/6782 25/08/2025 | Serial | 016 |
| Patient Name | Miss SRIJETA DAS | Contact No | 9073718332 |
| Address | 65/25/17 JAN NAGAR ROAD SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||