Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02149 | Date 30/05/2019 |
| Token No | SM/24-25/20516 15/01/2025 | Serial | 012 |
| Patient Name | Miss SWARNALI MITRA | Contact No | 9836730652 |
| Address | 14 PANCHANANTALA LANE | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||