Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13613 | Date 14/10/2025 |
| Token No | SM/25-26/2282 14/10/2025 | Serial | 005 |
| Patient Name | Mrs. DIPALI CHAKRABORTY | Contact No | 9836836763 |
| Address | 106 N.N. COLONY | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||