Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00326 | Date 01/11/2019 |
| Token No | SM/25-26/10777 21/11/2025 | Serial | 023 |
| Patient Name | Mr. ANSH DUBEY | Contact No | 8820474114 |
| Address | 97/Z/4 PRAVASHNAGAR SERAMPORE 712249 | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||