Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00032 | Date 07/09/2019 |
| Token No | SM/25-26/7707 10/09/2025 | Serial | 026 |
| Patient Name | Mrs. CHANDRAKALA JAISWAL | Contact No | 8583899114 |
| Address | 97/F/4 PRAVASHNAGAR SERAMPORE 712249 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||