Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 13843 | Date 09/12/2025 |
| Token No | SM/25-26/2928 09/12/2025 | Serial | 001 |
| Patient Name | Mrs. NANDINI DEBI | Contact No | 9576831706 |
| Address | JAILKHANA SERAMPORE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||