Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13320 | Date 29/07/2025 |
| Token No | SM/25-26/1456 29/07/2025 | Serial | 012 |
| Patient Name | Miss SITA KUMARI PANDIT | Contact No | 8910294519 |
| Address | 14 SATISH CHANDRA GHOSH LANE | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||