Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13732 | Date 14/11/2025 |
| Token No | SM/25-26/2625 14/11/2025 | Serial | 002 |
| Patient Name | Mrs. SANCHAITA DE MULLICK | Contact No | 9088495458 |
| Address | 613/B G.T. ROAD | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||