Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13010 | Date 21/05/2025 |
| Token No | SM/25-26/525 21/05/2025 | Serial | 010 |
| Patient Name | Miss SRUTI MAJUMDER | Contact No | 8910014115 |
| Address | 24A/4 DEY BAGAN LANE | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||