Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 12876 | Date 10/04/2025 |
| Token No | SM/25-26/110 10/04/2025 | Serial | 001 |
| Patient Name | Miss TIYASA MALLICK | Contact No | 8697547087 |
| Address | 5/1/T DINABANDHU CHATTERJEE LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||