Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00697 | Date 09/01/2020 |
| Token No | SM/25-26/11856 13/12/2025 | Serial | 001 |
| Patient Name | Miss SIMRAN RAJBHAR | Contact No | 8777378339 |
| Address | 82/A GURU GARDEN ROAD SERAMPORE 712249 | Age | 17 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||