Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01375 | Date 08/04/2020 |
| Token No | SM/25-26/11829 11/12/2025 | Serial | 056 |
| Patient Name | Mrs. BAISHNABI SINGH | Contact No | 8910816626 |
| Address | 100/B PRAVASHNAGAR SERAMPORE 712249 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||