Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 07694 | Date 19/08/2024 |
| Token No | SM/25-26/11862 13/12/2025 | Serial | 007 |
| Patient Name | Miss SANCHITA GOUR | Contact No | 8585018410 |
| Address | 23/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||