Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04255 | Date 30/05/2023 |
| Token No | SM/25-26/8238 19/09/2025 | Serial | 059 |
| Patient Name | Miss ANITA KUMARI | Contact No | 7686980471 |
| Address | 60/D GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 17 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||