Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00265 | Date 11/08/2018 |
| Token No | SM/25-26/2089 18/09/2025 | Serial | 012 |
| Patient Name | Mrs. REKHA DEY | Contact No | 8622032238 |
| Address | 90/C/3 DEY STREET | Age | 67 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||