Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09996 | Date 22/09/2025 |
| Token No | SM/25-26/8377 22/09/2025 | Serial | 084 |
| Patient Name | Mrs. USHA DEVI SINGH | Contact No | 8777258046 |
| Address | D2/302 SUBASHNAGAR HOUSING 161 M J ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||