Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09572 | Date 07/07/2023 |
| Token No | SM/25-26/2174 23/09/2025 | Serial | 011 |
| Patient Name | Mrs. SHANKARI DAS | Contact No | 9433021784 |
| Address | 46A BANERJEE PARA, SERAMPORE | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||