Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 14874 | Date 14/09/2026 |
| Token No | SM/25-26/6068 26/10/2026 | Serial | 018 |
| Patient Name | Mrs. SOHINI CHATTERJEE | Contact No | 8240270237 |
| Address | 54/H BAHIR SERAMPORE ROAD | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||