Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12545 | Date 17/01/2025 |
| Token No | SM/25-26/2635 14/11/2025 | Serial | 012 |
| Patient Name | Miss SHAMPA GHOSH | Contact No | |
| Address | 59 NEHERU NAGAR COLONY | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||