Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04607 | Date 25/07/2023 |
| Token No | SM/25-26/12347 24/12/2025 | Serial | 003 |
| Patient Name | Miss JAYA SINGH | Contact No | 8478905019 |
| Address | 137 NEW MAHESH SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||