Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 07171 | Date 27/06/2024 |
| Token No | SM/25-26/5000 19/07/2025 | Serial | 031 |
| Patient Name | Mrs. GUDIYA DEVI | Contact No | 8910973135 |
| Address | GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 45 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||