Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13025 | Date 24/05/2025 |
| Token No | SM/25-26/553 24/05/2025 | Serial | 013 |
| Patient Name | Mrs. SUDIPTA ROY | Contact No | 7003711674 |
| Address | 134/3/A/1 T B STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||