Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04508 | Date 14/07/2023 |
| Token No | SM/25-26/7251 01/09/2025 | Serial | 069 |
| Patient Name | Mrs. NANDINI DUBEY | Contact No | 8240495965 |
| Address | 9/A/1/190 M J ROAD PROVASHNAGAR SERAMPRE 712249 | Age | 15 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||