Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13509 | Date 12/09/2025 |
| Token No | SM/25-26/2017 12/09/2025 | Serial | 003 |
| Patient Name | Mrs. KAKALI SEN | Contact No | 9051761114 |
| Address | 149 THAKURBATI STREET | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||