Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12990 | Date 15/05/2025 |
| Token No | SM/25-26/450 15/05/2025 | Serial | 001 |
| Patient Name | Mrs. DIPALI KUNDU | Contact No | 9143400104 |
| Address | 31 DOSTI LANE | Age | 50 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||