Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 08667 | Date 05/02/2025 |
| Token No | SM/25-26/8274 20/09/2025 | Serial | 032 |
| Patient Name | Mrs. KAKALI MAJUMDAR | Contact No | 8902486159 |
| Address | 30/73 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||