Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09829 | Date 28/08/2025 |
| Token No | SM/25-26/9151 15/10/2025 | Serial | 040 |
| Patient Name | Miss RICHA GIRI | Contact No | 8210163507 |
| Address | 900 S K NAGAR PRAVASHNAGAR SERAMPORE 712249 | Age | 13 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||