Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12931 | Date 28/04/2025 |
| Token No | SM/25-26/277 28/04/2025 | Serial | 005 |
| Patient Name | Miss SRIMOYEE MUKHERJEE | Contact No | 9748395189 |
| Address | SIRISHTALA | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||