Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04347 | Date 28/04/2021 |
| Token No | SM/24-25/16999 20/06/2024 | Serial | 001 |
| Patient Name | Mrs. SUNITI DAS | Contact No | 7595879980 |
| Address | 73/33 JITEN LAHIRI ROAD | Age | 57 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||