Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13062 | Date 27/05/2025 |
| Token No | SM/25-26/622 27/05/2025 | Serial | 004 |
| Patient Name | Mrs. RINA HALDER | Contact No | 9830201795 |
| Address | 61E THAKURBATI STREET | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||