Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09978 | Date 18/09/2025 |
| Token No | SM/25-26/8161 18/09/2025 | Serial | 071 |
| Patient Name | Mrs. LAGMANO DEVI SHAW | Contact No | 8013880632 |
| Address | 49/5/H/80 KARLMARX SARANI KHIDDIRPORE KOLKATA 700023 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||