Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09991 | Date 22/09/2025 |
| Token No | SM/25-26/8301 22/09/2025 | Serial | 008 |
| Patient Name | Miss SREEJA NANDI | Contact No | 6289241427 |
| Address | 97/B PRAVASHNAGAR SERAMPORE 712249 | Age | 8 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||