Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 06660 | Date 29/04/2024 |
| Token No | SM/25-26/8332 22/09/2025 | Serial | 039 |
| Patient Name | Mrs. KUSUM DEVI | Contact No | 9088553817 |
| Address | 13/39 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||