Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13548 | Date 20/09/2025 |
| Token No | SM/25-26/2131 20/09/2025 | Serial | 005 |
| Patient Name | Mrs. RAM RATI DEBI | Contact No | 8583947200 |
| Address | K.C. BHATTACHARJEE STREET | Age | 44 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||