Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03667 | Date 30/01/2023 |
| Token No | SM/25-26/10311 12/11/2025 | Serial | 019 |
| Patient Name | Mr. JAI BHARAT SINGH | Contact No | 7044338884 |
| Address | 99/B/A PRABASHNAGAR SERAMPORE 712249 | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||