Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13730 | Date 13/11/2025 |
| Token No | SM/25-26/2619 13/11/2025 | Serial | 021 |
| Patient Name | Mrs. ILA SAHA | Contact No | 9230011223 |
| Address | 36/2 S.B. GHOSH LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||