Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12891 | Date 21/04/2025 |
| Token No | SM/25-26/159 21/04/2025 | Serial | 004 |
| Patient Name | Mrs. MIRA DAS... | Contact No | NOT GIVEN |
| Address | BANERJEE PARA | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||