Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09500 | Date 25/06/2025 |
| Token No | SM/25-26/10317 12/11/2025 | Serial | 025 |
| Patient Name | Mrs. AARTI BALMIKI | Contact No | 7003912509 |
| Address | C/2/309 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 33 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||