Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04718 | Date 04/08/2023 |
| Token No | SM/25-26/4735 15/07/2025 | Serial | 032 |
| Patient Name | Miss ISHITA SOM | Contact No | 7059526728 |
| Address | 102 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||