Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04635 | Date 27/07/2023 |
| Token No | SM/25-26/10302 12/11/2025 | Serial | 010 |
| Patient Name | Mr. JAY KUMAR GUPTA | Contact No | 6290163167 |
| Address | 72/A/A PRABASHNAGAR SERAMPORE 712249 | Age | 17 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||