Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13771 | Date 24/11/2025 |
| Token No | SM/25-26/2737 24/11/2025 | Serial | 024 |
| Patient Name | Mrs. SONALI MAL. | Contact No | 7449910543 |
| Address | 39/A S B GHOSH LANE | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||