Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09992 | Date 22/09/2025 |
| Token No | SM/25-26/8336 22/09/2025 | Serial | 043 |
| Patient Name | Mrs. SHAMPA MAJHI | Contact No | 9903160997 |
| Address | 119 NEW MAHESH SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||