Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01392 | Date 11/04/2020 |
| Token No | SM/25-26/8028 15/09/2025 | Serial | 044 |
| Patient Name | Mr. SUBHAM SINGH | Contact No | 8481010412 |
| Address | 97/K/3 PRAVASHNAGAR SERAMPORE 712249 | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||