Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09769 | Date 25/07/2023 |
| Token No | SM/25-26/426 12/05/2025 | Serial | 004 |
| Patient Name | Mrs. TINA PAL | Contact No | 7439295908 |
| Address | 11/1/2 S B GHOSH LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||