Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07707 | Date 20/08/2024 |
| Token No | SM/25-26/11966 15/12/2025 | Serial | 009 |
| Patient Name | Miss BINDI DAS | Contact No | 7890757105 |
| Address | 8/A/2/19 PRABASHNAGAR SERAMPORE 712249 | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||