Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02330 | Date 27/07/2022 |
| Token No | SM/25-26/12176 20/12/2025 | Serial | 016 |
| Patient Name | Mrs. GYANTI KUMARI | Contact No | 6290126445 |
| Address | 97/Z/3 PRAVASHNAGAR SERAMPORE 712249 | Age | 19 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||