Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13778 | Date 26/11/2025 |
| Token No | SM/25-26/2762 26/11/2025 | Serial | 002 |
| Patient Name | Mrs. CHAITALI. DEY | Contact No | 9339587938 |
| Address | 21 PANDIT KALINATH BHATTACHARYYA STREET | Age | 49 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||