Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09903 | Date 08/09/2025 |
| Token No | SM/25-26/7576 08/09/2025 | Serial | 006 |
| Patient Name | Mrs. PRATIMA BHARTI | Contact No | 9830452442 |
| Address | 97/Q/3 GURUGARDEN ROAD SERAMPORE 712249 | Age | 33 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||