Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 12758 | Date 10/03/2025 |
| Token No | SM/24-25/21283 10/03/2025 | Serial | 025 |
| Patient Name | Miss MADHURIMA GANGULY | Contact No | 8336835371 |
| Address | 14/A VIVEKANANDA LANE | Age | 14 YRS 2 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||