Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04403 | Date 01/07/2023 |
| Token No | SM/25-26/3430 12/06/2025 | Serial | 048 |
| Patient Name | Miss SOUMILI DEY | Contact No | 8100494822 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 16 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||