Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09576 | Date 16/07/2025 |
| Token No | SM/25-26/8119 18/09/2025 | Serial | 029 |
| Patient Name | Mrs. MOUSUMI DAS | Contact No | 8820294770 |
| Address | 65/25/42 M J ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||