Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 09178 | Date 26/04/2025 |
| Token No | SM/25-26/2112 16/05/2025 | Serial | 005 |
| Patient Name | Miss PINKI KUMARI | Contact No | 9693941643 |
| Address | 10 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||