Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09118 | Date 17/04/2025 |
| Token No | SM/25-26/785 17/04/2025 | Serial | 019 |
| Patient Name | Mrs. BIPASHA GHOSH | Contact No | 8013963420 |
| Address | 8/G/5 ZAMIDAR BAGAN LANE SERAMPORE 712203 | Age | 32 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||