Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 10107 | Date 29/10/2025 |
| Token No | SM/25-26/9623 29/10/2025 | Serial | 016 |
| Patient Name | Miss AYESHA SINGH | Contact No | 7890491624 |
| Address | 66/E/21 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||