Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05498 | Date 07/03/2022 |
| Token No | SM/25-26/2177 24/09/2025 | Serial | 003 |
| Patient Name | Miss KUSUMIKA MUKHERJEE | Contact No | 7980259071 |
| Address | 14A/18A SATISH CHANDRA GHOSH LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||