Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09055 | Date 07/04/2025 |
| Token No | SM/25-26/6840 25/08/2025 | Serial | 074 |
| Patient Name | Miss SANCHITA KUMARI | Contact No | |
| Address | 9/1/A/38 PRAVASHNAGAR SERAMPORE 712249 | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||