Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 10067 | Date 15/10/2025 |
| Token No | SM/25-26/9193 15/10/2025 | Serial | 082 |
| Patient Name | Mrs. KAKULI CHAKRABORTY | Contact No | 8910726670 |
| Address | 191/1 SHAHID GOPINATH NAGAR SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||