Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04001 | Date 14/08/2020 |
| Token No | SM/24-25/20574 17/01/2025 | Serial | 024 |
| Patient Name | Mrs. SUCHITRA DOLAI | Contact No | 8013672832 |
| Address | SERAMPORE COCKRAIN ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||