Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01045 | Date 05/10/2018 |
| Token No | SM/25-26/1132 09/07/2025 | Serial | 003 |
| Patient Name | Mrs. SUKLA MITRA | Contact No | 7044521830 |
| Address | 13 PANCHANAN TALA LANE | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||