Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13209 | Date 07/07/2025 |
| Token No | SM/25-26/1105 07/07/2025 | Serial | 009 |
| Patient Name | Mrs. GUNJA DEVI | Contact No | 9674489894 |
| Address | 5B GOPAL GANGULY LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||