Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12994 | Date 15/05/2025 |
| Token No | SM/25-26/457 15/05/2025 | Serial | 008 |
| Patient Name | Mrs. RUPA DEY | Contact No | 6291506709 |
| Address | 5G CHOWDHURI PARA LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||