Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11233 | Date 27/10/2026 |
| Token No | SM/25-26/22682 27/10/2026 | Serial | 018 |
| Patient Name | Miss PINKI CHOWDHURY | Contact No | |
| Address | SERAMPORE | Age | 15 Years,6 Months,19 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||