Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12519 | Date 11/01/2025 |
| Token No | SM/24-25/20448 11/01/2025 | Serial | 001 |
| Patient Name | Mrs. MAHUA DEY | Contact No | 9163000305 |
| Address | 5 DEY STREET | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||