Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05369 | Date 09/10/2023 |
| Token No | SM/25-26/8982 11/10/2025 | Serial | 048 |
| Patient Name | Mrs. DULARI DEVI | Contact No | 9903147125 |
| Address | 16/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 75 YRS Female |
| Token For | Visit Doctor,Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||