Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 03266 | Date 22/10/2019 |
| Token No | SM/25-26/1173 11/07/2025 | Serial | 006 |
| Patient Name | Mrs. MALATI DEY | Contact No | 6290892721 |
| Address | 13 DHARMATALA | Age | 67 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||