Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05224 | Date 05/01/2022 |
| Token No | SM/25-26/2933 09/12/2025 | Serial | 006 |
| Patient Name | Mrs. JHUMA BANERJEE | Contact No | 6291087554 |
| Address | 27 DEY STREET | Age | 45 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||