Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02058 | Date 27/06/2022 |
| Token No | SM/25-26/9333 17/10/2025 | Serial | 035 |
| Patient Name | Mrs. LAKSHMI NAYAK | Contact No | 8961682453 |
| Address | 13/56 B B GHOSH ROAD SARADA PALLY SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||