Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04093 | Date 25/04/2023 |
| Token No | SM/25-26/8548 25/09/2025 | Serial | 053 |
| Patient Name | Miss BRIJEETA ROY | Contact No | 6290728216 |
| Address | 1/D/2/A/1 K M GOSWAMI SARANI SERAMPORE 712201 | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||