Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07760 | Date 22/11/2022 |
| Token No | SM/25-26/2593 12/11/2025 | Serial | 020 |
| Patient Name | Mrs. KALYANI SANTRA | Contact No | 9874204137 |
| Address | 33 BHAGIRTHI LANE | Age | 57 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||