Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09901 | Date 08/09/2025 |
| Token No | SM/25-26/7574 08/09/2025 | Serial | 004 |
| Patient Name | Mrs. KOMAL KUMARI | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||