Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12821 | Date 22/03/2025 |
| Token No | SM/24-25/21439 22/03/2025 | Serial | 005 |
| Patient Name | Mrs. RUPA HALDER | Contact No | 8013410089 |
| Address | 22 K M BHATTACHARYA STREET | Age | 45 yrs Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||