Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09351 | Date 27/05/2025 |
| Token No | SM/25-26/10716 20/11/2025 | Serial | 029 |
| Patient Name | Mr. BISAL SAH | Contact No | 9088997636 |
| Address | 9/A/A/38 PRAVASHNAGAR SERAMPORE 712249 | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||