Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10027 | Date 08/10/2025 |
| Token No | SM/25-26/8756 08/10/2025 | Serial | 008 |
| Patient Name | Mrs. SAMPA PAL | Contact No | 7605837882 |
| Address | 472/A 3 NO NATUNGRAM RISHRA SERAMPORE 712248 | Age | 46 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||