Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 10005 | Date 24/09/2025 |
| Token No | SM/25-26/8463 24/09/2025 | Serial | 054 |
| Patient Name | Miss RIMI GHORAI | Contact No | 9123805803 |
| Address | 102 G T ROAD WEST MALLICKPARA SERAMPORE 712203 | Age | 9 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||