Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 09914 | Date 08/09/2025 |
| Token No | SM/25-26/7637 08/09/2025 | Serial | 067 |
| Patient Name | Mrs. REKHA MONDAL BHOWMICK | Contact No | 8240613101 |
| Address | 32 MALLICKPARA BASUNDHARA APARTMENT SERAMPORE 712203 | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||