Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04253 | Date 30/05/2023 |
| Token No | SM/25-26/6927 27/08/2025 | Serial | 001 |
| Patient Name | Mrs. PUJA RAJBHAR | Contact No | 7449804191 |
| Address | 97/T PRAVASHNAGAR SERAMPORE 712249 | Age | 31 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||