Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13371 | Date 13/08/2025 |
| Token No | SM/25-26/1649 13/08/2025 | Serial | 004 |
| Patient Name | Mrs. RITA DEBI | Contact No | 9523718763 |
| Address | 11/D/1/A S B GHOSH LANE | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||