Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10769 | Date 09/11/2023 |
| Token No | SM/24-25/21077 22/02/2025 | Serial | 014 |
| Patient Name | Miss PRIYANKA DAS (MALIK) | Contact No | 9804022437 |
| Address | 22 THAKUR BATI STREET, 186 R.K ROAD BAIDYABATI | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||