Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 09811 | Date 25/08/2025 |
| Token No | SM/25-26/6865 25/08/2025 | Serial | 099 |
| Patient Name | Mrs. MANORAMA SINGH | Contact No | 9875402787 |
| Address | 26/F/A PRAVASHNAGAR SERAMPORE 712249 | Age | 67 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||