Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09092 | Date 10/04/2025 |
| Token No | SM/25-26/6677 21/08/2025 | Serial | 043 |
| Patient Name | Mr. OM KUMAR SHAW | Contact No | 7596973725 |
| Address | 66E/13 PRAVASHNAGAR SERAMPORE 712249 | Age | 9 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||