Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09995 | Date 22/09/2025 |
| Token No | SM/25-26/8786 08/10/2025 | Serial | 038 |
| Patient Name | Mrs. CHANDRAWATI DEBI SHAW | Contact No | 8450094160 |
| Address | 66/D/21 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||