Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12271 | Date 28/10/2024 |
| Token No | SM/25-26/1618 11/08/2025 | Serial | 011 |
| Patient Name | Mrs. MITA DEY | Contact No | 8697361176 |
| Address | 53 PANCHANAN TALA LANE | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||