Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12929 | Date 28/04/2025 |
| Token No | SM/25-26/2961 11/12/2025 | Serial | 009 |
| Patient Name | Mrs. CHAMPA DEBI | Contact No | 9331445744 |
| Address | 33 N L BHATTACHARJEE STREET | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||