Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02099 | Date 30/06/2022 |
| Token No | SM/25-26/8572 25/09/2025 | Serial | 077 |
| Patient Name | Mrs. KAKALI DUTTAGUPTA | Contact No | 8910666140 |
| Address | C/121/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 60 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||