Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13867 | Date 13/12/2025 |
| Token No | SM/25-26/2995 13/12/2025 | Serial | 011 |
| Patient Name | Miss PRISHA GOSWAMI | Contact No | 7439692782 |
| Address | 107A THAKURBATI SYTREET | Age | 2 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||