Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04746 | Date 17/08/2021 |
| Token No | SM/25-26/1738 26/08/2025 | Serial | 005 |
| Patient Name | Mrs. SANDHYA APAT | Contact No | 9330802928 |
| Address | 2A ACHARYA K C BHATTACHARYA STREET | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||