Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03476 | Date 23/12/2022 |
| Token No | SM/25-26/12450 29/12/2025 | Serial | 019 |
| Patient Name | Miss ASHA SINGH | Contact No | 8583023473 |
| Address | 3/A B B GHOSH ROAD SERAMPORE 712203 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||