Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 07734 | Date 23/08/2024 |
| Token No | SM/25-26/12356 24/12/2025 | Serial | 012 |
| Patient Name | Miss PALLABI DAS | Contact No | 9874775832 |
| Address | 38/B B B GHOSH ROAD SERAMPORE 712203 | Age | 12 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||