Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04332 | Date 15/06/2023 |
| Token No | SM/25-26/9602 28/10/2025 | Serial | 019 |
| Patient Name | Mr. SATISH GUPTA | Contact No | 8240193151 |
| Address | 122 PRABASHNAGAR SERAMPORE 712249 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||