Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10229 | Date 27/11/2025 |
| Token No | SM/25-26/11085 27/11/2025 | Serial | 038 |
| Patient Name | Mr. PIYUSH SINGH | Contact No | 9681306937 |
| Address | 78/A BAISHNABPARA SECOND LANE SERAMPORE 712203 | Age | 18 YRS Male |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||