Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04335 | Date 26/04/2021 |
| Token No | SM/25-26/1063 02/07/2025 | Serial | 016 |
| Patient Name | Mrs. KANTI DEBI | Contact No | 6291618593 |
| Address | DEY GHAT LANE | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||