Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13681 | Date 31/10/2025 |
| Token No | SM/25-26/2461 31/10/2025 | Serial | 005 |
| Patient Name | Mrs. SHARMISTHA DUTTA | Contact No | 7998083906 |
| Address | 3A A K C BHATTACHARJEE STREET | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||