Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03896 | Date 09/03/2023 |
| Token No | SM/25-26/11388 03/12/2025 | Serial | 020 |
| Patient Name | Miss CHANDANI SHAW | Contact No | 9674513019 |
| Address | 97/F/4/1 PRAVASHNAGAR SERAMPORE 712249 | Age | 16 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||