Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04797 | Date 26/08/2021 |
| Token No | SM/25-26/2545 07/11/2025 | Serial | 005 |
| Patient Name | Mrs. KUSUM BHARTI | Contact No | 8420593743 |
| Address | SERAMPORE DHULI PARA | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||