Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13874 | Date 16/12/2025 |
| Token No | SM/25-26/3008 16/12/2025 | Serial | 008 |
| Patient Name | Miss SARNALI BANERJEE | Contact No | 9073333837 |
| Address | 16 CHOWDHURI PARA LANE | Age | 25 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||