Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 14816 | Date 29/08/2026 |
| Token No | SM/25-26/5619 29/08/2026 | Serial | 003 |
| Patient Name | Mrs. SAMPA MUKHERJEE | Contact No | 9088822836 |
| Address | 31B KAILASH CHATTERJEE LANE | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||