Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 10115 | Date 30/10/2025 |
| Token No | SM/25-26/9698 30/10/2025 | Serial | 055 |
| Patient Name | Mrs. MANJU DEVI | Contact No | 9304251561 |
| Address | 5/1/Z DINABANDHU CHATTERHEE LANE SERAMPORE 712202 | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||