Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10103 | Date 29/10/2025 |
| Token No | SM/25-26/9608 29/10/2025 | Serial | 001 |
| Patient Name | Mrs. RENU UPADHYAY | Contact No | |
| Address | PRAVASHNAGAR SERAMPORE 712249 | Age | 45 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||