Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10219 | Date 22/11/2025 |
| Token No | SM/25-26/10884 22/11/2025 | Serial | 099 |
| Patient Name | Miss TRISHA KUMARI | Contact No | 9236618631 |
| Address | 55 ROYLAND ROAD SERAMPORE 712201 | Age | 6 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||