Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12122 | Date 21/09/2024 |
| Token No | SM/25-26/520 21/05/2025 | Serial | 005 |
| Patient Name | Miss ROHINI MUKHERJEE | Contact No | 8777252774 |
| Address | 6 CHOWDHURY PARA | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||