Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13563 | Date 23/09/2025 |
| Token No | SM/25-26/2166 23/09/2025 | Serial | 003 |
| Patient Name | Miss STUTI MUKHERJEE | Contact No | 9831870501 |
| Address | 2/A ANATH BANDHU MUKHERJEE LANE | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||