Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09159 | Date 23/04/2025 |
| Token No | SM/25-26/3384 12/06/2025 | Serial | 002 |
| Patient Name | Mrs. LADLI PAL | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||