Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11548 | Date 16/05/2024 |
| Token No | SM/25-26/1185 11/07/2025 | Serial | 018 |
| Patient Name | Mrs. SUSMITA KOLEY.,. | Contact No | 7596858355 |
| Address | 16/1 DEY ST | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||