Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00667 | Date 04/01/2020 |
| Token No | SM/25-26/8957 11/10/2025 | Serial | 023 |
| Patient Name | Mrs. DIPTI NAG | Contact No | 7449911910 |
| Address | 30/66 TARAPUKUR COLONY SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 110/70 mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||