Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12661 | Date 13/02/2025 |
| Token No | SM/25-26/1130 09/07/2025 | Serial | 001 |
| Patient Name | Mrs. KALPANA KARMAKAR.. | Contact No | 7685918571 |
| Address | 105 J.N. LAHIRI ROAD | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||