Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 07230 | Date 28/06/2024 |
| Token No | SM/25-26/10065 07/11/2025 | Serial | 003 |
| Patient Name | Miss SIDDHI DUBEY | Contact No | 8240495965 |
| Address | 9/A/1/190 M J ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 28 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||