Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12802 | Date 19/03/2025 |
| Token No | SM/24-25/21374 19/03/2025 | Serial | 012 |
| Patient Name | Miss DIPANJALI GHOSH | Contact No | 7980755107 |
| Address | 86/A AKHRA BATI LANE | Age | 17 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||