Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09676 | Date 30/07/2025 |
| Token No | SM/25-26/5595 30/07/2025 | Serial | 061 |
| Patient Name | Miss ASHMI SARDAR | Contact No | 8100345746 |
| Address | 21/22 BHATTACHARYA GARDEN BYE LANE NABAGRAM BAIDYABATI M 712203 | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||