Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13577 | Date 09/10/2025 |
| Token No | SM/25-26/2200 09/10/2025 | Serial | 001 |
| Patient Name | Mrs. SOUMITA CHAKRABORTY | Contact No | 6289067625 |
| Address | 56 DHULIPARA LANE | Age | 32 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||