Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02930 | Date 18/10/2022 |
| Token No | SM/25-26/8576 25/09/2025 | Serial | 081 |
| Patient Name | Mrs. KRISHNA ROY | Contact No | 9836708469 |
| Address | 65/19/7 CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||