Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06087 | Date 14/06/2022 |
| Token No | SM/25-26/1494 31/07/2025 | Serial | 006 |
| Patient Name | Mrs. BANDANA SHEET | Contact No | 8017278346 |
| Address | 28/5 S B GHOSH LANE | Age | 30 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||