Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00540 | Date 12/12/2019 |
| Token No | SM/25-26/12518 30/12/2025 | Serial | 021 |
| Patient Name | Miss KHUSHI SINGH | Contact No | 6290184456 |
| Address | 43/20/E PRAVASHNAGAR SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 29 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||