Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09837 | Date 29/08/2025 |
| Token No | SM/25-26/7103 29/08/2025 | Serial | 019 |
| Patient Name | Mrs. LISA DAS | Contact No | 8013156326 |
| Address | 80 RISHI BANKIM SARANI SERAMPORE 712201 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||