Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 09729 | Date 11/08/2025 |
| Token No | SM/25-26/6167 11/08/2025 | Serial | 032 |
| Patient Name | Miss NIMISHA SHARMA | Contact No | 7596963361 |
| Address | 6/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 17 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||