Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09984 | Date 19/09/2025 |
| Token No | SM/25-26/8860 09/10/2025 | Serial | 044 |
| Patient Name | Mrs. PAYEL NAG | Contact No | 8585876234 |
| Address | 30/66 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||