Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04759 | Date 09/08/2023 |
| Token No | SM/25-26/11089 27/11/2025 | Serial | 042 |
| Patient Name | Miss SUMATI DAS | Contact No | 8100093899 |
| Address | 72/A/6 PROVASNAGAR SERAMPORE M 712249 | Age | 14 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||