Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11809 | Date 18/07/2024 |
| Token No | SM/24-25/19420 23/10/2024 | Serial | 009 |
| Patient Name | Mrs. SUSOMA BISWAS | Contact No | 6296857453 |
| Address | 39 DHULI PARA LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||