Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13544 | Date 19/09/2025 |
| Token No | SM/25-26/2118 19/09/2025 | Serial | 007 |
| Patient Name | Mrs. DIPALI CHAKRABORTY | Contact No | 8777693211 |
| Address | 137A G.T. ROAD, MANIKTALA | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||