Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10054 | Date 13/10/2025 |
| Token No | SM/25-26/9029 13/10/2025 | Serial | 032 |
| Patient Name | Miss DONA BISHNU | Contact No | 8777470881 |
| Address | 20/C PRAVASHNAGAR SERAMPORE 712249 | Age | 21 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||