Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13873 | Date 16/12/2025 |
| Token No | SM/25-26/3006 16/12/2025 | Serial | 006 |
| Patient Name | Mrs. KUNTI DEVI | Contact No | 8478967423 |
| Address | 26 K C BHATTACHARYA STREET | Age | 56 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||