Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12649 | Date 12/02/2025 |
| Token No | SM/25-26/3122 31/12/2025 | Serial | 002 |
| Patient Name | Mrs. RUPA BAG | Contact No | 9163552914 |
| Address | 4 A B GARDEN LANE | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||