Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01410 | Date 13/04/2020 |
| Token No | SM/25-26/9410 22/10/2025 | Serial | 001 |
| Patient Name | Miss LAXMI SINGH | Contact No | 7890498163 |
| Address | 100/B PRABASHNAGAR SERAMPORE 712249 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||