Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 13800 | Date 29/11/2025 |
| Token No | SM/25-26/2812 29/11/2025 | Serial | 001 |
| Patient Name | Mrs. KAKALI DEY | Contact No | 9674533238 |
| Address | 3/168 MAHESH COLONY | Age | 43 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||