Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01115 | Date 02/03/2020 |
| Token No | SM/25-26/11010 26/11/2025 | Serial | 004 |
| Patient Name | Miss SACHI RAJBHAR | Contact No | 8777378339 |
| Address | 82/A GURU GARDEN ROAD SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||