Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09973 | Date 18/09/2025 |
| Token No | SM/25-26/8130 18/09/2025 | Serial | 040 |
| Patient Name | Mrs. CHAMPA DAS | Contact No | 9681488214 |
| Address | 89 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 35 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||