Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13627 | Date 16/10/2025 |
| Token No | SM/25-26/2309 16/10/2025 | Serial | 001 |
| Patient Name | Mrs. KANAKLATA SHIL | Contact No | 9748576824 |
| Address | BANERJEE PARA | Age | 56 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||