Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09964 | Date 15/09/2025 |
| Token No | SM/25-26/8036 15/09/2025 | Serial | 052 |
| Patient Name | Mrs. TUMPA SIL | Contact No | 9051714539 |
| Address | 193 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||