Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10174 | Date 28/08/2023 |
| Token No | SM/25-26/1858 02/09/2025 | Serial | 010 |
| Patient Name | Miss JYOTI KUMARI(DEBI) | Contact No | 8777563744 |
| Address | 14 NO J N LAHIRI ROAD SREERAMPORE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||