Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13576 | Date 08/10/2025 |
| Token No | SM/25-26/2199 08/10/2025 | Serial | 018 |
| Patient Name | Miss LALITA KUMARI | Contact No | 9674489894 |
| Address | 5B GOPAL GANGULY LANE | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||