Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10187 | Date 17/11/2025 |
| Token No | SM/25-26/12213 20/12/2025 | Serial | 053 |
| Patient Name | Mrs. SANJANA HELA | Contact No | 8100635112 |
| Address | 66/B/5 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||