Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13565 | Date 23/09/2025 |
| Token No | SM/25-26/2168 23/09/2025 | Serial | 005 |
| Patient Name | Miss SAMPRITI CHATTERJEE | Contact No | 9051700026 |
| Address | 150/1 THAKURBATI STREET | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||