Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09918 | Date 10/09/2025 |
| Token No | SM/25-26/7683 10/09/2025 | Serial | 002 |
| Patient Name | Mr. AYUSH SINGH | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 15 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||