Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09813 | Date 25/08/2025 |
| Token No | SM/25-26/6888 25/08/2025 | Serial | 122 |
| Patient Name | Mrs. REBA ROY | Contact No | 8420145450 |
| Address | 30/33 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 82 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||