Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10291 | Date 12/12/2025 |
| Token No | SM/25-26/11846 12/12/2025 | Serial | 008 |
| Patient Name | Mrs. DEEPA RAJBHAR | Contact No | 9123858363 |
| Address | 73/A PRAVASHNAGAR SERAMPORE 712249 | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||