Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13278 | Date 23/07/2025 |
| Token No | SM/25-26/1521 04/08/2025 | Serial | 006 |
| Patient Name | Mrs. MONOJAN BEGUM | Contact No | 7439118846 |
| Address | K C BHATTACHARJEE STREET | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||