Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07602 | Date 07/08/2024 |
| Token No | SM/25-26/11050 27/11/2025 | Serial | 003 |
| Patient Name | Miss JHUMA DAS | Contact No | 9836563586 |
| Address | 20 BAJAR BYE LANE SERAMPORE 712201 | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||