Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13321 | Date 29/07/2025 |
| Token No | SM/25-26/1457 29/07/2025 | Serial | 013 |
| Patient Name | Mrs. DROUPADI BHAR | Contact No | 9123691742 |
| Address | AMTA (LOCAL 39B SASHIBHUSAN GHOSH LANE) | Age | 68 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||