Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09777 | Date 19/08/2025 |
| Token No | SM/25-26/6869 25/08/2025 | Serial | 103 |
| Patient Name | Mrs. SMRITI BHOWMICK | Contact No | 8620879171 |
| Address | 55/1/A RAJYADHARPUR 1 NO GOVT COLONY MALLICKPARA SERAMPORE 712203 | Age | 36 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||