Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03572 | Date 06/12/2019 |
| Token No | SM/25-26/284 28/04/2025 | Serial | 012 |
| Patient Name | Mrs. PAYAL DAS | Contact No | 7003410770 |
| Address | 3 BAISHNAB PARA 2ND LANE | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||