Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09968 | Date 18/09/2025 |
| Token No | SM/25-26/8310 22/09/2025 | Serial | 017 |
| Patient Name | Mrs. GURIYA DEVI | Contact No | 6291784402 |
| Address | A/433 GURUGARDEN ROADPRAVASHNAGAR SERAMPORE 712249 | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||