Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09588 | Date 10/07/2023 |
| Token No | SM/25-26/2742 24/11/2025 | Serial | 029 |
| Patient Name | Mrs. GUDDI SANA PARWEEN | Contact No | 8777211973 |
| Address | 27 DR. N.L. BHATTACHARYA STREET | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||