Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05115 | Date 26/11/2021 |
| Token No | SM/25-26/2242 10/10/2025 | Serial | 010 |
| Patient Name | Mrs. RIPA KUNDU | Contact No | 8981372223 |
| Address | 5B/5 DEY STREET | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||