Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03402 | Date 14/12/2022 |
| Token No | SM/25-26/8857 09/10/2025 | Serial | 041 |
| Patient Name | Mrs. KANTI DEVI | Contact No | 9330151562 |
| Address | 97/A/4 PROVASNAGAR SERAMPORE 712249 | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||