Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05183 | Date 22/12/2021 |
| Token No | SM/24-25/20923 12/02/2025 | Serial | 008 |
| Patient Name | Mrs. DIPA BISWAS. | Contact No | 9432650155 |
| Address | 91A THAKUR BATI STREET | Age | 63 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||