Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13357 | Date 07/08/2025 |
| Token No | SM/25-26/1579 07/08/2025 | Serial | 023 |
| Patient Name | Mrs. GOURI MALLICK | Contact No | 7449792838 |
| Address | 77/A THAKURBATI STREET | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||