Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10290 | Date 11/12/2025 |
| Token No | SM/25-26/12230 20/12/2025 | Serial | 070 |
| Patient Name | Miss BANDANA KUMARI | Contact No | 8013682024 |
| Address | 60/C GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||