Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00562 | Date 17/12/2019 |
| Token No | SM/25-26/9394 21/10/2025 | Serial | 003 |
| Patient Name | Mrs. SHILA DEVI | Contact No | 8274996618 |
| Address | 100/B/2/A PRAVASNAGAR SERAMPORE 712249 | Age | 64 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||