Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13319 | Date 29/07/2025 |
| Token No | SM/25-26/1453 29/07/2025 | Serial | 009 |
| Patient Name | Mrs. JAYASHREE MONDAL | Contact No | 7890735635 |
| Address | 5/A PITAMBAR DEY LANE | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||