Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10312 | Date 18/12/2025 |
| Token No | SM/25-26/12096 18/12/2025 | Serial | 009 |
| Patient Name | Mrs. BABITA DEVI | Contact No | 8448548835 |
| Address | 55 ROYLAND ROAD SERAMPORE 712201 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||