Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 09147 | Date 21/04/2025 |
| Token No | SM/25-26/983 21/04/2025 | Serial | 078 |
| Patient Name | Miss RINKI DAS | Contact No | 9433214771 |
| Address | PURBAPARA PRAVASHNAGAR SERAMPORE 712249 | Age | 10 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||