Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 06657 | Date 29/04/2024 |
| Token No | SM/25-26/11691 08/12/2025 | Serial | 063 |
| Patient Name | Miss PINKI KUMARI CHOWDHURY | Contact No | 7044766069 |
| Address | 43/D PURBAPARA PRAVASHNAGAR SERAMPORE 712249 | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||