Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04465 | Date 09/06/2021 |
| Token No | SM/25-26/2702 21/11/2025 | Serial | 006 |
| Patient Name | Mrs. MOUSUMI BOSE | Contact No | 9088710687 |
| Address | 14 KAILASH CHATTERJEE LANE | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||