Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10104 | Date 29/10/2025 |
| Token No | SM/25-26/9609 29/10/2025 | Serial | 002 |
| Patient Name | Mrs. LATIKA DAS | Contact No | 9007653568 |
| Address | 43/16/3 PRAVASHNAGAR SERAMPORE 712249 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||