Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 07386 | Date 06/07/2024 |
| Token No | SM/25-26/8254 20/09/2025 | Serial | 012 |
| Patient Name | Miss ANKITA DHAM | Contact No | 7688020247 |
| Address | D/149/Y TARAPUKUR GOVT QUARTER MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||