Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07905 | Date 07/12/2022 |
| Token No | SM/25-26/1262 17/07/2025 | Serial | 008 |
| Patient Name | Miss SUBHASHREE PAL | Contact No | 877787965 |
| Address | 44/1/E N.L. BHATTACHARYA STREET | Age | 11 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||