Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02816 | Date 29/09/2022 |
| Token No | SM/25-26/12558 31/12/2025 | Serial | 005 |
| Patient Name | Mrs. PALBI KUMARI | Contact No | 7596820845 |
| Address | 97/S/1/5 PRABASHNAGAR SERAMPORE 712249 | Age | 20 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 41 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||