Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03036 | Date 03/11/2022 |
| Token No | SM/25-26/12546 30/12/2025 | Serial | 049 |
| Patient Name | Miss RITIKA KUMARI KAHAR | Contact No | 6291242362 |
| Address | 75 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||