Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04657 | Date 26/07/2021 |
| Token No | SM/24-25/16494 25/05/2024 | Serial | 015 |
| Patient Name | Mrs. RATNALEKHA DAS | Contact No | 9432427960 |
| Address | 3 LALIT MOHAN BHATTACHARJEE STREET | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||