Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09551 | Date 07/07/2025 |
| Token No | SM/25-26/4546 11/07/2025 | Serial | 001 |
| Patient Name | Miss SHIBANI ROY | Contact No | 6290360046 |
| Address | 97/4/1/A GURU GARDEN ROAD PAVASHNAGAR SERAMPORE 712249 | Age | 14 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||