Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02106 | Date 30/06/2022 |
| Token No | SM/25-26/9048 13/10/2025 | Serial | 051 |
| Patient Name | Mrs. HEMANTI SHAW | Contact No | 9038843329 |
| Address | 30/35 TARAPUKUR COLONY SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 94 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||