Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09794 | Date 21/08/2025 |
| Token No | SM/25-26/6710 21/08/2025 | Serial | 076 |
| Patient Name | Miss NANDINI PATWA | Contact No | 7059822644 |
| Address | 97/H/5 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||