Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03520 | Date 28/12/2022 |
| Token No | SM/25-26/9686 30/10/2025 | Serial | 043 |
| Patient Name | Mrs. URMILA DEVI | Contact No | 8777216802 |
| Address | 165/A/1 PRABASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||