Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04881 | Date 19/08/2023 |
| Token No | SM/25-26/8481 24/09/2025 | Serial | 072 |
| Patient Name | Mrs. MOUMITA NANDY | Contact No | 8335068116 |
| Address | 4/A PITAMBAR DEY LANE SERAMPORE 712201 | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||