Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09571 | Date 16/07/2025 |
| Token No | SM/25-26/4746 16/07/2025 | Serial | 003 |
| Patient Name | Miss BIJALI DAS | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE712249 | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||