Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13842 | Date 08/12/2025 |
| Token No | SM/25-26/2925 08/12/2025 | Serial | 020 |
| Patient Name | Mrs. SUTAPA DEY | Contact No | 8918571797 |
| Address | 20 R.B. SARANI | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||