Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09832 | Date 28/08/2025 |
| Token No | SM/25-26/7058 28/08/2025 | Serial | 067 |
| Patient Name | Miss ISHITA PASWAN | Contact No | 9674071989 |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 8 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||