Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13696 | Date 03/11/2025 |
| Token No | SM/25-26/2483 03/11/2025 | Serial | 019 |
| Patient Name | Mrs. GITA MANNA | Contact No | |
| Address | DEY STREET | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||