Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 13883 | Date 20/12/2025 |
| Token No | SM/25-26/3054 20/12/2025 | Serial | 001 |
| Patient Name | Mrs. SUMANA MITRA | Contact No | 9051587831 |
| Address | 16A/6 BARA BAGAN LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||