Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09742 | Date 13/08/2025 |
| Token No | SM/25-26/8107 18/09/2025 | Serial | 017 |
| Patient Name | Mrs. MANGALI RABIDAS | Contact No | |
| Address | 66/B/1 GURUGARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 60 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||