Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09802 | Date 25/08/2025 |
| Token No | SM/25-26/6792 25/08/2025 | Serial | 026 |
| Patient Name | Mrs. KAMALA DAS | Contact No | 8820072150 |
| Address | 30/54 TARAPUKUR LANE MALLICKPARA SERAMPORE 712249 | Age | 67 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||